Overactive Bladder in Men: Causes, Diagnosis, and Treatment
Overactive Bladder: What Is It?
Overactive bladder (OAB) is a common set of symptoms that can include frequent urination, a constant urge to go, leakage, and night-time urination. Nearly 33 million Americans struggle with symptoms of overactive bladder, and thirty percent of all men have OAB.
It’s possible that even more men are suffering from OAB, but go unreported. Many men feel embarrassed about having symptoms of OAB, and delay speaking to their doctors. It’s important to talk to your doctor about your OAB, as there are a variety of effective treatments that can help.
Symptoms of OAB
There are several symptoms associated with OAB. You may have just one, or all of them. OAB may include an urgent need to urinate. The need is so great that you may not be able to control it. You may also need to go up to eight times a day, and experience nocturia, the need to go at least two times overnight.
Another common symptom of OAB is called urge incontinence, which means that you may have some leakage when you feel the urge to urinate. It may coincide with laughing, sneezing, or physical activity.
OAB and the Prostrate
In about two-thirds of cases of OAB in men, the cause is an enlarged prostrate. The prostate is a gland that only men have. It sometimes enlarges as men age, which can result in a blockage in the flow of urine. This blockage causes symptoms of OAB. Although an enlarged prostate does not account for all cases of OAB in men, many who are treated for the symptoms are assumed to have a bladder obstruction caused by an enlarged prostate.
Other Causes of OAB in Men
An enlarged prostate is the cause of OAB in most men, but there are numerous other factors that can lead to symptoms. An infection in the bladder, bladder stones, or bladder cancer can all cause OAB. Neurological conditions, such as a stroke or Parkinson’s disease, can also lead to OAB because of nerve damage that results in sending incorrect signals to the bladder.
It’s also possible for temporary factors to cause symptoms of OAB. If you drink a lot of fluids, especially those that are caffeinated or contain alcohol, if you take medications that increase urine output, or if you are constipated, you might experience an increased need to urinate.
Diagnosis of OAB
If you are experiencing symptoms of OAB, your doctor will want to give you a thorough physical exam. You will also likely need to have your urine tested to look for signs of infection or stones. Your doctor may also give you any of several available tests that evaluate the functioning of your bladder.
These include measuring how much urine is left in your bladder after going to the bathroom, measuring the rate of flow when you urinate, and measuring the pressure in and around your bladder. Based on test results, your doctor can give you a considered diagnosis and discuss your treatment options.
Treating OAB with Lifestyle Changes
The first type of treatment your doctor will likely recommend is making healthy lifestyle changes. This could involve changing what you eat and drink, keeping a urination record and sticking to a bathroom schedule, maintaining a healthy weight, using a catheter to completely empty the bladder, or using absorbent pads. You may also try a bladder training routine, which aims to help you learn how to delay urinating when you feel the urge to go.
Treatment with Medications
When lifestyle changes are ineffective at controlling the symptoms of OAB, your doctor may have you try medications. For men whose OAB is caused by an enlarged prostate, a class of drugs called alpha blockers help to relax the surrounding muscles to reduce urine blockage.
Other drugs that may help treat the symptoms of OAB include those that reduce spasms in the bladder. These medications work to reduce the urge to go, and there are several different drugs that can be used.
In some cases of OAB, the symptoms are related to nerves sending inappropriate signals to the bladder. If these nerve signals can be regulated, the symptoms of OAB can be reduced. For this type of treatment, you will have a small device implanted under your skin near your tailbone.
A battery powers the device, which delivers electrical impulses to the nerves running to your bladder. Like a pacemaker in the heart, the impulses control the contractions of the bladder. This treatment is reversible, and the device can be easily removed.
Surgery: A Last Resort
If the symptoms of your OAB are severe, and other treatments are not effective, your doctor may suggest surgery. If your OAB is caused by an enlarged prostate, a surgeon can remove part of the gland, or ablate it with a laser. This type of surgery also has a high success rate.
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