OVERVIEW
Overactive bladder, also called OAB, causes a frequent and sudden urge to urinate that may be difficult to control. You may feel like you need to pass urine many times during the day and night and may also experience leakage of urine (urgency incontinence).
Symptoms
You may experience the following common symptoms:
- A sudden urge to urinate that is difficult to control, running to the bathroom
- Unintentional loss of urine immediately after an urgent need to urinate (urgency incontinence)
- Frequent urination (urinating sooner than every 2 hours)
- Waking up more than two times in the night to urinate (nocturia)
Causes
Sometimes the cause of overactive bladder is unknown. Some known causes include neurological disorders (i.e. stroke, MS), Diabetes, hormonal changes in women during menopause, abnormalities in the bladder, bladder outlet obstruction (i.e. enlarged prostate, urethral scar formation), various medications (i.e. water pills), excess consumption of caffeine or alcohol, or certain foods (i.e. artificial sweeteners, spicy foods).
Diagnosis/Evaluation
1) What to know before your visit:
- During your visit, your doctor will ask you questions regarding your medical history and will perform an exam with focus on your abdomen and genitalia
2) Other tests that may be performed during or after your visit
- Urinalysis: This evaluates for any blood in the urine or infection
- Post-void residual: The physician will often ask you to void and then check to make sure you are emptying your bladder.
- Urine flow: The physician may have you urinate in a funnel to assess the speed of your urinary stream.
- Cystoscopy: This is a procedure performed in the office where the physician inserts a small scope into the urethra to assess for any abnormalities
- Urodynamics: This is a test where a small tube is inserted into the urethra and another into the rectum to help measure the pressures in the bladder during urination.
Treatment
NON-SURGICAL TREATMENTS
- Behavioral changes: Decreasing caffeine (i.e. coffee, soda, tea) and alcohol intake, avoiding artificial sweeteners (i.e. Splenda, Equal, Sweet n’ Low), and stopping fluid intake 2-3 hours before you go to bed may improve your lower urinary tract symptoms.
- Timed voiding: Urinating at defined intervals to retrain your bladder
- Avoid constipation
- Pelvic floor physical therapy/Biofeedback: This will help either strengthen or relax the muscles of your pelvic floor, which may be contributing to your urinary symptoms
- Anti-cholinergics or Beta-agonists: Medical therapy that relax the muscles of the bladder making urination less frequent and urgent. These medications may also improve the amount of times you wake up at night to urinate.
SURGICAL TREATMENTS
- Botox: A minimally invasive procedure where Botox is injected into the muscles of the bladder to improve relaxation and decrease urgency, frequency, and waking up at night to urinate.
- Interstim: A pacemaker for the bladder often placed in 2 stages. The first procedure is typically performed in the office without anesthesia. It works by modulating the nerves to the bladder and improving urinary urgency, frequency, and waking up at night to urinate.
- Tibial nerve stimulation: Similarly to Interstim, this works to modulate the nerves to the bladder and decrease urgency, frequency, and waking up at night to urinate.
Schedule an appointment with a MidLantic Urology physician near you today!