Overactive Bladder Syndrome

Overactive Bladder Overview: Symptoms, Causes and Treatments Image

Overactive bladder, or OAB, is one of the most common bladder problems. OAB occurs when the smooth muscle of the bladder (the detrusor muscle) contracts without warning. Between 17 and 20 million people in the United States suffer from overactive bladder. Only about twenty percent seek medical help. Most are either too embarrassed to ask for help, or believe that little can be done to treat their bladder problems.

Symptoms of OAB

Overactive bladder is defined by three main symptoms: frequency, urgency, and urge incontinence. OAB sufferers need to urinate with great frequency: often enough that work, socializing and relationships all suffer. People with overactive bladder problems may not get enough sleep, as they wake up several times a night to empty their bladders.

Urgency occurs because the detrusor muscle contracts suddenly, leaving OAB patients with little time to reach a bathroom. These sudden contractions can also cause urge incontinence, where the bladder suddenly voids, often completely. Fear that this will happen in public leaves many OAB sufferers housebound.

Overactive bladder affects all areas of a person ‘s life. Many sufferers employ a coping strategy known as “toilet mapping. ” They memorize the locations of toilets in areas they frequent. While this may help, it also restricts individuals to areas with which they are familiar. Medical treatment would allow these same individuals to greatly broaden their ability to travel, work, and play.

Causes of Overactive Bladder

Many factors contribute to overactive bladder. Bladder stones cause blockages in the bladder and irritate the bladder walls. Removal of the stones cures the OAB symptoms. Certain medications have OAB-like side effects, and the symptoms disappear when the medication is stopped. Be sure to list any medications you take when discussing OAB with your doctor. Bladder infections can also cause OAB.

Trauma to the pelvic or lower abdominal area during surgery is a common cause of overactive bladders. Men sometimes develop OAB after prostate surgery, especially if the urinary sphincter is damaged or compromised during surgery.

Bladder Stones

Neurogenic Bladder Problems

OAB may occur because of neurogenic (flaccid or spastic) bladder problems. Nerve damage interferes with communication between the bladder and the brain. The brain simply does not receive the message that the bladder is full.

Neurogenic bladder problems can be traced to strokes, spinal cord lesions and nerve-debilitating diseases such as Parkinson ‘s and Multiple Sclerosis.

Treatments and Therapies for OAB

Overactive bladder is a very treatable disorder. Where bladder infection, bladder stones or medication side effects are the cause of the problem, removing the irritant returns the bladder to normal. When the cause is more permanent in nature, OAB often responds well to other treatments.

Bladder retraining is often recommended for OAB patients. Scheduling regular times to urinate reduces the chances of accidents if the bladder contracts. Learning to contract the urinary sphincter through biofeedback can be used in combination with the voiding schedule.

Oral medications, such as oxybutynin chloride and tolterodine, relax the bladder muscle and reduce involuntary contractions. Most patients report relief from overactive bladders after two weeks of medication.

Surgery for OAB is considered a last resort. In cases where other treatments and therapies prove ineffective, augmentation of the bladder may be considered. A portion of the large intestine is removed and used to enlarge the bladder. The added bladder capacity reduces the frequency with which patients urinate.

Resources

urologychannel.com. (nd). Overactive bladder. Retrieved March 7, 2002, from www.urologychannel.com/bladdercontrol/index.shtml.

American Foundation for Urologic Diseases. (nd). Confronting incontinence and OAB. Retrieved March 4, 2002, from www.incontinence.org/confronting/index.html.