An overactive bladder causes a sudden urge to urinate. It can also trigger involuntary loss of urine, known as incontinence. Overactive bladder affects about 33 million Americans. Women are more affected than men.
It can be difficult to manage symptoms because an overactive bladder may be unpredictable. This can cause some people with the condition to limit their social activities. However, there are several treatments available that can help you manage your symptoms.
Experiencing occasional incontinence doesn't mean you have an overactive bladder. Urine leakage can also occur for other reasons. It can happen if you’re laughing too hard. You may also experience loss of urine if you’ve been fighting the urge to urinate for an extended period of time. An overactive bladder is determined by the frequency and urgency of urination. Symptoms include:
- an urgent and uncontrollable need to urinate
- frequent involuntary loss of urine
- frequent urination (more than eight times in a 24-hour period)
- waking up more than once a night to use the bathroom
Your kidneys produce urine and that urine travels to your bladder. Then, your brain sends signals that tell your body to urinate. Your pelvic floor muscles relax and allow urine to exit your body.
An overactive bladder causes your bladder muscles to contract involuntarily. This gives the sensation of needing to urinate frequently even if your bladder is not full.
Different conditions and factors can cause symptoms of an overactive bladder:
- drinking too much fluid
- taking medications that increase urine production
- urinary tract infections
- consumption of caffeine, alcohol or other bladder irritants
- failure to completely empty the bladder
- bladder abnormalities, such as bladder stones
The exact case of an overactive bladder is unknown. The risk of developing this condition increases with age, but an overactive bladder isn’t a normal part of aging. So you shouldn't ignore symptoms. Seeing your doctor can help make sure you get the correct diagnosis.
Menopause can raise the risk of an overactive bladder in women. Men that have an enlarged prostate also have a higher risk. Frequent and urgent urination may also occur after a brain or spinal cord injury. Having multiple sclerosis or a stroke can interfere with the signals your brain sends to your bladder.
Your doctor may complete several diagnostic tests in order to diagnose the cause of your symptoms.
Urine sample (Urinalysis): Your urine will be tested for any abnormalities, including blood. A urinalysis can help identify a urinary tract infection or other urinary tract problems.
Physical examination: This allows your doctor to feel for tenderness around your abdomen, kidneys or check for an enlarged prostate. Your doctor may refer you to a urologist for one or more of the following tests.
Bladder scan: Uses an ultrasound to measure the amount of urine left in your bladder after you urinate.
Urodynamic testing: A variety of tests that assess the bladder’s ability to hold and store urine.
Cystoscopy: A lighted scope inserted into your bladder while you are sedated. This helps your doctor determine if your symptoms are caused by any abnormalities within your bladder such as bladder stones or tumors. Biopsies can be taken as well.
An overactive bladder can cause people to avoid being in public so they can avoid accidents. This can affect the quality of your life. It can also trigger isolation and emotional distress.
Some people with an overactive bladder develop anxiety or depression. Because frequent urination can interfere with sleep and keep you awake at night, there’s also the risk of insomnia and sleep deprivation.
Numerous treatments are available to help you manage symptoms of an overactive bladder. You’ll work closely with your doctor to come up with an effective treatment plan. Options can include medication to relieve symptoms and reduce urges. Other treatments can include:
Pelvic floor physical therapy: There are physical therapists who specialize in the muscles of the pelvis. Through targeted muscle exercises and strengthening, they can help manage a variety of urinary problems, including urgency, frequency, and nighttime symptoms. Talk to your doctor to find those specialists in your area.
Botox: Small doses of Botox injections can paralyze bladder muscles. This stops them from contracting too often. Results last about 12 weeks, so you’ll need repeated treatments. Possible side effects include an inability to empty the bladder completely.
Nerve stimulation: This procedure changes the electrical signal of the nerves that carry impulses to the bladder. The procedure can be performed using a small wire inserted into the low back or a small needed inserted through the skin of the lower leg. Some studies have shown this can relieve the frequency and urgency of an overactive bladder.
Surgery: Your doctor may suggest surgery to increase your bladder’s capacity if your symptoms don’t improve with medication, nerve stimulation, or other therapies.
Living with an overactive bladder can be challenging. Doctor-prescribed treatments and lifestyle changes can help you reduce the frequency of urges. Lifestyle changes include:
- limit your intake of caffeine and alcohol, which can increase urine production and irritate the bladder
- ask your doctor about your recommended fluid intake per day
- shed extra weight to reduce stress incontinence caused by physical activity
You can also schedule bathroom trips every couple of hours to develop a routine, instead of waiting until you feel the urge.
Pelvic floor exercises can help train your bladder. These exercises involve voluntarily tightening your pelvic floor muscles and learning how to strengthen and control these muscles.
If you’re unable to completely control an overactive bladder, wear absorbent pads underneath your clothes to help manage urine leakage.
The most important thing to do if you have symptoms of overactive bladder is talk to your doctor. This condition is often underreported due to embarrassment. But medical science has come a long way in understanding and treating this condition. You and your doctor can develop a treatment plan that will be ideal for you.