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Overactive Bladder: Causes, Symptoms, Diagnosis & Treatment

Do you often feel the sudden urge to urinate that you find difficult to control? Well, then you might be having an overactive bladder leading to involuntary loss of urine, known as urge incontinence.

The person with an overactive bladder may feel embarrassed or isolate themselves, which could hamper their work and social life. But if you understand the condition and its cause, it will be easier to manage.

What Causes Overactive Bladder?

The proper functioning of the urinary bladder depends on a healthy urinary tract. Several conditions can affect the communication pathways between the nerves and bladder muscles and cause the bladder muscles to contract involuntarily. This involuntary contraction causes an overactive bladder where you feel the constant urge to urinate [1] .

Some of the underlying causes of overactive bladder are the following:

  • A decline in cognitive functioning due to ageing which makes it difficult for your bladder to receive the brain signals.
  • Diabetes
  • Taking medications that increase the production of urine.
  • Neurological disorders like stroke and multiple sclerosis.
  • Urinary tract infections.
  • Bladder stones or tumour in the bladder.
  • Excess caffeine or alcohol consumption.
  • Enlarge prostate, constipation or any previous operations that obstruct bladder flow.
  • Incomplete emptying of bladder.

Symptoms Of Overactive Bladder

  • Uncontrollable urge to urinate.
  • Frequent urination - more than 8 times in a span of 24 hours.
  • Waking up multiple times at night to urinate.

The symptoms may vary from person to person. The frequent need to urinate can disrupt your work activity [2] .

Overactive Bladder In Women

Overactive bladder is more common among women after menopause which can be the result of low oestrogen levels. The symptoms are urinating twice every night or at least eight times daily, and not being able to control urination. It can be treated with surgery, medicines and physical exercise [3] .

Overactive Bladder In Men

Men also suffer from an overactive bladder with symptoms like experiencing urine leakage, not able to control urination and urinating up to eight times per day [4] . It has been reported that in most men, the overactive bladder is the result of an enlarged prostate. An enlarged prostate is more common in older men and treating it will ease the symptoms [5] .

Overactive Bladder In Children

Children are also likely to have an overactive bladder [6] . The symptoms include accidental urination or urine leakage, frequent urge to urinate, urinating more than eight times a day and feeling of fullness in the bladder even after emptying it. As children get older, the symptoms start decreasing as they have better control on their bladder. However, if the symptoms remain the same, consult a doctor.

Risk Factors Of Overactive Bladder [7]

  • Obesity
  • Age
  • Diabetes
  • Enlarged prostate
  • Gender

Complications Of Overactive Bladder

Overactive bladder can affect your quality of life where you might face anxiety issues, experience emotional distress or depression, sexual problems and sleep disturbances.

Diagnosis Of Overactive Bladder [8]

  • The doctor will take some tests like urine sample (urinalysis) which is done by collecting a sample of your urine and testing it for any abnormalities. It will help identify a urinary tract infection or other associated problems.
  • Doctors will conduct a physical examination, checking for tenderness around your abdomen and kidneys or check for an enlarged prostate.
  • Bladder scan is done to measure the amount of urine left in the bladder after urination.
  • Cystoscopy test is done to check if there are any bladder stones or tumour by inserting a lighted scope into your bladder.
  • Urodynamic testing is done to understand the bladder's ability to hold and store urine.

Treatment Options For Overactive Bladder

  • Behavioural interventions are the first choice for treating and managing overactive bladder. It includes pelvic floor muscle exercises, healthy weight, intermittent catheterization, scheduled toilet trips, bladder training and absorbent pads.
  • Medications such as tolterodine, oxybutynin, trospium, mirabegron, darifenacin, and fesoterodine can be helpful in relieving the symptoms of the overactive bladder [9] .
  • Bladder injections like onabotulinumtoxinA, which is a protein derived from bacteria, can also help. When the protein is injected in small doses into the bladder tissues, it paralyses the muscles partially. It can help with severe urge incontinence. The effect of the injection lasts for five months or more [10] .
  • Nerve stimulation is another treatment option that helps regulate the nerve impulses to the bladder. This relieves the symptoms of overactive bladder [11] .
  • If none of the above treatment options relieve your symptoms then surgery is the only option. Surgery is done either to increase the bladder capacity or removing the bladder.

Natural Remedies For Overactive Bladder

  • Essential oils can help calm the nerves and muscles of the bladder and ease the symptoms. The essential oils which are used for overactive bladder treatment are lavender oil, clary sage oil, pumpkin seed oil and ylang-ylang oil.
  • Herbal medicines like gosha-junki-gan, Ganoderma lucidum and corn silk also work [12] .
  • Research shows that acupuncture is another way to relieve the symptoms [13] .

Diet And Lifestyle Changes

  • Limit drinks like caffeine, alcohol, and carbonated drinks as they might aggravate your symptoms.
  • Speak to your doctor on how much fluid should you drink daily. Not drinking enough water or drinking excess will increase the urge to urinate.
  • Overweight people are at a greater risk of urinary incontinence so, losing weight is necessary.
  • People who are gluten sensitive experience more symptoms of overactive bladder.
  • Avoid foods that irritate your bladder lining like citrus fruits, spicy foods, artificial sweeteners, artificial flavourings, honey, milk, chocolate, corn syrup and vinegar.
  • Quit smoking.
  • Get regular physical exercise.
View Article References
  1. [1] Nitti V. W. (2002). Clinical impact of overactive bladder. Reviews in urology, 4 Suppl 4(Suppl 4), S2-6.
  2. [2] Rapariz, M., Mora, A. M., & Roset, M. (2018). Impact of overactive bladder symptoms on work activity: The ACTIVHA study. Actas Urológicas Españolas (English Edition), 42(3), 176-184.
  3. [3] ABREU, G. E. D., DOURADO, E. R., ALVES, D. D. N., ARAUJO, M. Q. D., MENDONÇA, N. S. P., & BARROSO JUNIOR, U. (2018). Functional constipation and overactive bladder in women: a population-based study. Arquivos de gastroenterologia, 55, 35-40.
  4. [4] Dmochowski, R. R., & Gomelsky, A. (2009). Overactive bladder in males. Therapeutic advances in urology, 1(4), 209-21.
  5. [5] Macdiarmid S. A. (2008). Maximizing the treatment of overactive bladder in the elderly. Reviews in urology, 10(1), 6-13.
  6. [6] Ramsay, S., & Bolduc, S. (2017). Overactive bladder in children. Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 11(1-2Suppl1), S74-S79.
  7. [7] Teleman, P. M., Lidfeldt, J., Nerbrand, C., Samsioe, G., Mattiasson, A., & WHILA Study Group. (2004). Overactive bladder: prevalence, risk factors and relation to stress incontinence in middle‐aged women. BJOG: An International Journal of Obstetrics & Gynaecology, 111(6), 600-604.
  8. [8] Willis-Gray, M. G., Dieter, A. A., & Geller, E. J. (2016). Evaluation and management of overactive bladder: strategies for optimizing care. Research and reports in urology, 8, 113-22.
  9. [9] Lam, S., & Hilas, O. (2007). Pharmacologic management of overactive bladder. Clinical interventions in aging, 2(3), 337-345.
  10. [10] Ramos, H. L., Castellanos, L. T., Esparza, I. P., Jaramillo, A., Rodríguez, A., & Bencardino, C. M. (2017). Management of overactive bladder with onabotulinumtoxinA: systematic review and meta-analysis. Urology, 100, 53-58.
  11. [11] MacDiarmid, S. A., John, M. S., & Yoo, P. B. (2018). A pilot feasibility study of treating overactive bladder patients with percutaneous saphenous nerve stimulation. Neurourology and urodynamics.
  12. [12] Chughtai, B., Kavaler, E., Lee, R., Te, A., Kaplan, S. A., & Lowe, F. (2013). Use of herbal supplements for overactive bladder. Reviews in urology, 15(3), 93-6.
  13. [13] Zhao, Y., Zhou, J., Mo, Q., Wang, Y., Yu, J., & Liu, Z. (2018). Acupuncture for adults with overactive bladder: A systematic review and meta-analysis of randomized controlled trials. Medicine, 97(8), e9838.

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