Do you find yourself going to the restroom frequently throughout the day or waking up multiple times a night to urinate? Do you experience sudden urges to urinate, sometimes accompanied by episodes of urine leakage?
If your answer to either of these questions is yes, you may be suffering from overactive bladder (OAB). But don’t worry – you are not alone. Though OAB is an abnormality and should not be ignored, it is a common condition, affecting about 50 million people in the United States. That includes 40 percent of women and 30 percent of men.
Because overactive bladder is most common in those over the age of 65 (or 40 for women), many people think overactive bladder is just a normal part of aging. However, this is not the case. In fact, OAB can even alert you to more serious problems – and it is a treatable condition.
The first step to getting treated is recognizing the signs of overactive bladder. Keep reading to learn more about what overactive bladder is, what causes it, and the symptoms that accompany it.
What is overactive bladder?
In general, OAB is a problem that affects the bladder’s ability to hold urine. As a healthy bladder is filled with urine, it stretches and expands to accommodate the increased volume. Specialized nerves in the bladder lining can then sense when the bladder is full and signal to the brain that it is time to empty.
In the normal situation, you are able to voluntarily control when to empty the bladder – that is, you note the sensation of needing to urinate and are able to hold it until you get to the bathroom. You voluntarily relax your pelvic floor muscles, allowing the urine to exit the bladder.
For people with OAB, however, there is thought to be abnormal communication between the brain and the bladder such that the bladder muscle contracts involuntarily. Thus, they may experience a strong, sudden urge to urinate even when the bladder volume is low. This can lead to not only frequent urination, but also involuntary urine leakage (incontinence).
OAB can be further categorized into two types: dry and wet. In OAB dry, incontinence is not present, whereas in OAB wet, sudden urges to urinate can be accompanied by leakage. To get an accurate diagnosis, it’s important for patients to communicate their symptoms clearly to their doctors no matter how uncomfortable it may be.
Common signs of overactive bladder
It’s important to note that the symptoms and signs of overactive bladder can differ from person to person and fluctuate over time, so it is not always easy to spot the condition right away. However, the most common signs of overactive bladder include:
- Frequent urination throughout the day (more than 8 times in 24 hours)
- Waking up multiple times per night to urinate
- Sudden urges to urinate, sometimes accompanied by involuntary leakage (urinary incontinence)
The above illustration shows the difference between a normal bladder that’s full and an overactive bladder.
What is the main cause of overactive bladder?
Part of what makes OAB tricky to spot and treat is that it has a variety of potential causes. However, many causes stem from problems with the urinary tract. If you do experience symptoms of OAB, it is important to discuss them with your doctor so that you may be alerted to any potential problems with your urinary tract health.
Other main causes of OAB include:
- Medications that increase urine production
- Drinking an excess of fluids
- Consumption of diuretics such as caffeine or alcohol
- Urinary tract infections
- Other bladder conditions, e.g., bladder stones or bladder cancer
- Certain neurological conditions
OAB and quality of life
OAB can significantly disrupt your quality of life, including disruptions to your sleep and sometimes an exacerbation of conditions like depression and anxiety. Suffering from embarrassing leaks or constantly having to schedule your day around proximity to a restroom can cause undue stress and make it difficult to function in work and life.
Fortunately, you do not have to live with this condition. Several treatment options exist to help manage your OAB symptoms. The first step is communicating with your doctor and obtaining the right diagnosis.
Diagnosing symptoms of overactive bladder
Someone experiencing the signs of overactive bladder should contact their primary care doctor. Doctors typically perform several tests to rule out other conditions, including urinalysis, physical exam, bladder scan, urodynamic testing, or cystoscopy. Doctors may also refer patients to urologists, who specialize in bladder tissue health.
How is OAB treated?
There are essentially three levels of treatment along the OAB patient care pathway. As with many health conditions, the treatment pathway for those with OAB begins with conservative options and moves on to the most intensive interventions:
- Behavioral Interventions
- Advanced Therapies
Behavioral Interventions for OAB
Behavioral interventions are recommended as the first level of treatment, as they are the least invasive and resource intensive. These can include:
- Exercises to strengthen your pelvic floor muscles, e.g., Kegel exercises
- Maintaining a healthy body weight
- Modification to your diet, e.g., avoiding spicy foods
- Modifying yourfluid intake, including drinking fluids in moderation or avoiding caffeine and alcohol
- Bladder training
- Keeping a bladder diary to track symptoms
Medication for OAB
If behavioral changes are unable to provide symptom relief, you may need to move to the next level of treatment: medications. The goal of these medications is to help relax your bladder so you have more control of your pelvic floor muscles and go less often.
Advanced Therapies for OAB
If symptom relief is still not achieved or you experience unwanted side effects from the medications, third-line advanced therapies may be the solution. These include surgeries, devices, and other specialized therapies, including Sacral Neuromodulation, Botox®*, and Percutaneous Tibial Nerve Stimulation (PTNS).
Axonics Therapy is a clinically proven long-term therapy that helps restore normal communication between the brain and the bladder, which may reduce or eliminate OAB symptoms.
If you think you are showing signs of overactive bladder, talk to your doctor about your symptoms. Together, you can find the right treatment solution to regain control.
To learn more about living with an overactive bladder, including tips and info, check out the Axonics® Therapy Blog.