Overactive bladder is a problem with bladder storage function that causes a sudden urge to urinate. The urge may be difficult to suppress, and overactive bladder can lead to the involuntary loss of urine (incontinence).
If you have overactive bladder, you may feel embarrassed, isolate yourself, or limit your work and social life. The good news is that after a brief evaluation to determine the cause of overactive bladder, you can receive treatments that may greatly reduce or eliminate the symptoms of overactive bladder and help you manage their effect on your daily life.
Signs and symptoms of overactive bladder may mean you:
Although you may be able to get to the toilet in time when you sense an urge to urinate, frequent and nighttime urination, as well as the need to suddenly "drop everything," can disrupt your life.
When to see a doctor
Sometimes, people assume that an overactive bladder or urinary incontinence is just a normal part of aging, and simply deal with the condition by wearing absorbent undergarments or pads. But, symptoms of urgency and incontinence aren't an inevitable part of getting older, and treatments are available that might help you. Additionally, it's important to talk to your doctor because an overactive bladder and urge incontinence may occur as a result of a serious underlying problem, such as a cancerous tumor.
Normal bladder function
It all starts with your kidneys, which produce urine. Urine leaves the kidneys and travels down a pair of long tubes to your bladder. Urine drains from your bladder through an opening at the bottom (neck) and flows out a short tube called the urethra (u-REE-thrah). In women, the urethral opening is located just above the vagina. In men, the urethral opening is at the tip of the penis.
Your bladder expands like a balloon to accommodate urine from the kidneys. When it's reached about a third of its capacity, nerve signals alert your brain, and you sense that your bladder is starting to fill. As it fills more, you'll feel the need to urinate (void). When you urinate, nerve signals coordinate the relaxation of the pelvic floor muscles and the muscles surrounding the neck of the bladder and upper portion of the urethra (urinary sphincter muscles). The muscles of the bladder contract, forcing urine out.
Involuntary bladder contractions
Several factors may cause or contribute to signs and symptoms similar to those of overactive bladder. Your doctor may try to rule them out during an evaluation because they require other specialized treatments. These factors include:
In some cases, doctors can't identify the specific cause of your overactive bladder.
Female urinary system
Your bladder stores urine produced by your kidneys and expels it through a tube called the urethra. In women, the urethral opening is above the vagina. ...
Male urinary system
Your bladder stores urine produced by your kidneys and expels it through a tube called the urethra. In men, the urethral opening is at the tip of the penis. ...
As you grow older, you're at increased risk of developing overactive bladder, and you're also more susceptible to diseases and disorders that can contribute to other problems with bladder function, such as enlarged prostate and diabetes. Although common among older adults, an overactive bladder isn't considered a normal part of aging.
As might be expected, urge and any urge-associated incontinence can affect your overall quality of life, and can also be detrimental to your well-being. People with significant disruption from an overactive bladder are more susceptible to:
Some people may also have a disorder called mixed incontinence, when both urge incontinence and stress incontinence occur. Stress incontinence is the loss of urine when you exert physical stressors or pressure on your bladder, as when you cough or laugh.
Preparing for your appointment
If you experience signs and symptoms of overactive bladder, you're likely to start by seeing your family doctor or a general practitioner. However, you may be referred to a urologist or a urogynecologist for diagnosis and treatment. When you make your appointment, ask your doctor if you should keep a bladder diary for a few days. You record when, how much and what kind of fluids you consume, when you urinate, whether you feel an urge to urinate and whether you experience incontinence. Your diary may reveal patterns that help your doctor understand your symptoms and identify contributing factors.
Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions ahead of time can help get the most out of your appointment. For overactive bladder, some basic questions to ask your doctor include:
What to expect from your doctor
Tests and diagnosis
In a basic diagnostic work-up, your doctor will look for clues that may also indicate contributing factors. The exam will likely include:
Your doctor will review the results of these tests with you and suggest a treatment strategy.
Treatments and drugs
Your doctor is likely to recommend a combination of treatment strategies to alleviate your symptoms.
Common side effects of these drugs include dry eyes and dry mouth, but drinking water to quench thirst can aggravate symptoms of overactive bladder. Extended-release forms of these medications, including the skin patch, may cause fewer side effects.
Your doctor may recommend that you suck on a piece of sugar-free candy or chew sugar-free gum to alleviate dry mouth, and use eyedrops to keep your eyes moist. Over-the-counter preparations, such as Biotene products, can be helpful for chronically dry mouth.
Sacral nerve stimulation
Lifestyle and home remedies
No complementary or alternative therapies have been proved to successfully treat overactive bladder. Research suggests that therapies such as reflexology and hypnotherapy aren't effective in treating this condition.
Alternative treatments that might be helpful include:
Coping and support
Living with overactive bladder can be difficult. Consumer education and advocacy support groups such as the National Association for Continence (NAFC) can provide you with online resources and information, connecting you with people who experience overactive bladder and urge incontinence. Support groups offer a venue for voicing concerns and learning new coping strategies and often provide motivation to maintain self-care strategies.
Educating your family and friends about overactive bladder and your experiences with it may help you establish your own support network and alleviate some of the embarrassment you may feel.
These healthy lifestyle choices may reduce your risk of overactive bladder:
Last Updated: 2010-09-28
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