Overactive Bladder (OAB)

That sudden urge to urinate can be frustrating and difficult to control. But it’s treatable.

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.

Common symptoms:

• A sudden urge to urinate that is difficult to control and results in running to the bathroom
• Unintentional loss of urine immediately after an urgent need to urinate
• Urinating sooner than every 2 hours
• Waking up more than two times in the night to urinate (nocturia)

Sometimes the cause of overactive bladder is unknown. Some known causes include:

• Abnormalities in the bladder
• Bladder outlet obstruction (i.e., enlarged prostate in men, urethral scar formation)
• Diabetes
• Hormonal changes in women during menopause
• Kidney disease
• Medications (i.e., water pills)
• Caffeine, alcohol, or certain foods (i.e., artificial sweeteners, spicy foods)
• Nerve damage
• Neurological disorders (i.e., Stroke, multiple sclerosis, Parkinson’s disease)

In addition, signals sent from the sacral nerves (at the base of the spine) to the bladder may cause the muscle surrounding the bladder to contract, even if the bladder isn’t full.

It is helpful if you keep a diary for a few days before your doctor’s visit to track time of urination, the amount of urine, leakage, and foods and beverages consumed.

What to know before your visit to Advanced Urology Institute:

• During your visit, your doctor will ask you questions regarding your medical history and will perform an exam with a focus on your abdomen and genitalia.

Other tests that may be performed during or after your visit include:

• 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 check for any abnormalities.
• Urodynamics: This is a test where a very small catheter is inserted into the urethra and another into the rectum to help measure the pressures in the bladder during filling and urination.

NON-SURGICAL TREATMENTS

Behavioral changes: Decreasing caffeine (i.e., coffee, soda, tea) and alcohol intake, avoiding artificial sweeteners, 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.
• Avoiding constipation
• Healthy weight: If you’re overweight, losing weight may ease symptoms of an overactive bladder.
• Pelvic floor exercises: Kegel exercises can be effective for both men and women. They strengthen your pelvic floor muscles and your urinary sphincter. These strengthened muscles can help you stop the bladder’s involuntary contractions.
• Bladder training: You train yourself to delay urination when you feel an urge. You begin with small delays, such as 30 minutes, and gradually work your way up to urinating every three to four hours.
• Medications: Anticholinergics or Beta-agonists can relax the muscles of the bladder making urination less frequent and urgent. These medications may also improve the number 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.
• Sacral neuromodulation (InterStim or Axonics): This tiny device is implanted to help your nerves function normally by delivering mild electrical pulses. It works much like a pacemaker. During a two-week trial period, your doctor determines if the device is right for you. If so, the device is implanted in your upper buttock region and sacrum .
• Percutaneous Tibial Nerve Stimulation (PTNS): Similar to InterStim or Axonics, but doesn’t require a procedure to implant a device. PTNS stimulates the nerves to the bladder and decrease urgency, frequency, and waking up at night to urinate.