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Overactive Bladder (OAB), also called urge incontinence, spastic bladder, and irritable bladder syndrome, is a condition that causes a sudden, urgent desire to pass urine even if the bladder is not full. This urge to urinate, which is difficult to suppress, can lead to the involuntary loss of urine (incontinence); however, OAB is not the same condition as stress incontinence. In OAB, episodes of urine leakage, or incontinence, are always accompanied by the urge to urinate, as compared to stress incontinence in which episodes of incontinence are unanticipated and brought about by actions such as coughing, laughing, or jumping. According to the Urology Care Foundation, approximately 33 million Americans have overactive bladder.
OAB is characterized by spasms of urinary muscles that lead to the sudden urge to urinate. Often, OAB is idiopathic, meaning that the specific cause of the involuntary contractions of the muscles of the bladder that lead to the urge to urinate is unknown. However, the following factors may contribute to OAB:
While the exact cause of OAB is unknown, researchers have identified several risk factors associated with the condition. These include:
Age. OAB can strike at any age, but the risk increases with age. The National Association for Continence reports that one in five adults over the age of 40 has OAB.
Gender. There are conflicting reports on whether or not women are more likely to develop OAB than men. According to the National Association for Continence, 17% of women over the age of 18 are affected by overactive bladder as compared to 16% of men 18 and over. However when grouped with urinary incontinence (UI), an overlapping condition in which urine unexpectedly leaks from the bladder without the urge to urinate, the distribution of risk changes dramatically. The same report from the National Association for Continence states that women are twice as likely to suffer from OAB than men if the condition is grouped with the overlapping UI. Hormonal activity related to menstruation, pregnancy, and menopause can lead to weakened pelvic-floor muscles that increase the risk of OAB in women, however men, too, have added risk with the possibility of an enlarged prostate.
Obesity Extra pounds increase the pressure on the bladder, which may lead to involuntary contractions. Obesity may also lessen blood flow and nerve activity in the bladder, and puts individuals at a higher risk for certain OAB-connected conditions such as diabetes.
Spinal Cord Injury Impairment of the signals sent to the bladder via the spinal cord can cause involuntary contractions.
In many cases, a general physician will be able to make an OAB diagnosis.
You physician’s work-up will include the following:
Depending on the results of your examination, your doctor may order the following tests:
Because OAB is so closely connected to other urinary disorders, it can be difficult to separate the symptoms of OAB from other conditions.
The main and distinguishing symptom of OAB is:
The following symptoms are common among OAB patients, but are not exclusive to the disorder:
There is no cure for overactive bladder, but with proper treatment and medication, OAB can be controlled in most people. [NOTE: hyperlink ‘treatment’ and ‘medication’ to ‘alternative treatment’ and ‘medication’ sections, respectively.
Living with an overactive bladder can be difficult. The following tips can help you manage your symptoms and live comfortably with OAB:
Previously, OAB was not screened for mainly because of a time-consuming diagnosis process. However, an OAB diagnostic tool has just been validated and is expected to make its way into general practices in the near future. The screening tool is an 8 line questionnaire in which patients are asked to rate the degree of severity of any urinary symptoms they may be experiencing, and has been shown to increase the efficiency of OAB diagnosis and treatment. If the results of a patient’s screening test are positive, he or she may wish to confirm the diagnosis with one or several diagnostic tests.
The causes of overactive bladder (OAB) are associated with factors that are often unavoidable – including involuntary muscle contractions as a result of a neurological disorder or obstruction. This makes preventing the condition difficult. Therefore, OAB prevention focuses on reducing OAB symptoms by making lifestyle and dietary changes.
Many of the available medication options for OAB have significant side effects. Unwanted complications can occur if these drugs are accidentally combined with other medications so be sure to tell your doctor and pharmacist about all the prescription and nonprescription medications and supplements you are taking.
Medication to treat OAB
Anticholinergics work to stop the urinary muscle and bladder spasms that characterize OAB by blocking nerve transmission. They are the first-choice medications for treating OAB.
Because anticholinergics work by blocking nerve transmission, they are not recommended for people who already suffer from or are at a high risk for a neurological disorder such as Alzheimer’s disease. Because of this, anticholinergics are often not prescribed to elderly patients.
Other medications include:
Always talk to your doctor before starting any new medication regimen. He or she will be able to foresee any potential risks and/or medication interactions.
Treatments for OAB
In addition to medications, there are many available treatments to help control OAB symptoms.
Surgery to treat OAB
Surgical options are considered when other modes of treatment have failed or have shown to have serious side effects.
Alternative and complementary treatments may help control symptoms associated with OAB. As with any sort of alternative treatment, speak with your doctor about what may work best for you before beginning a treatment plan.
The following treatments have been identified as potentially beneficial for patients with OAB, however as with most alternative treatments, scientific research about the effects of each treatment is limited, and therefore no definitive confirmation of their effectiveness exists:
Call your doctor if you have been diagnosed with OAB and these symptoms come on suddenly:
Also be sure to contact your doctor if you experience anything you think may be a side effect of a medication or treatment. Communication is the best way to ensure efficient treatment.
Your doctor is here to help. Here are some questions you may want to ask about your condition:
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