Overactive Bladder

Sufferers of overactive bladder often feel embarrassed by their condition and the accidents associated with it.  However, studies show that the symptoms of overactive bladder affect up to a quarter of men and nearly half of women at some point in their lives.  Sufferers will be relieved to know that the symptoms of overactive bladder frequently resolve themselves in less than a year.

The four symptoms associated with overactive bladder are: urgency, frequency, nocturia, and urge incontinence:

  • Urgency is the most basic symptom of an overactive bladder.  Because no objective/measurable criteria for urgency are used, using urgency as a diagnostic indicator is controversial
  • Frequency, on the other hand, indicates an overactive bladder if a person urinates more than eight times a day
  • Nocturia is waking from sleep to urinate.  Typically, waking from sleep to urinate more than once a night is seen as an indicator of overactive bladder
  • Urge incontinence is involuntary loss of urine

Overactive bladder is frequently confused for stress urinary incontinence, which is a different disorder caused by stress.  It can also be confused with a urinary tract infection,  or even cancer.  These disorders have different treatments, so it is important to get a correct diagnosis.  Many of the other similar disorders involve pain while urinating, which is not typically associated with overactive bladder.

Overactive bladder can be treated in a number of ways.  Many of the easiest are simple lifestyle modifications including restriction of fluid intake and avoidance of caffeine.  It is impossible to urinate with an empty bladder, so drinking strategically is the most effective way to avoid accidents.  Doing Kegel exercises can also reduce the occurrence of incontinence.

Other non-drug treatments can include sacral nerve stimulation, which is when doctors implant a device which stimulates nerves with an electrical impulse.  When stimulated, the nerves signal the muscles in the pelvic floor to contract, which rebuilds the strength in these muscles and improves the ability of the patient to control their bladder.

There are also a range of medications which can be effective in treating overactive bladder.  Not all drugs will be equally effective for each patient, but none of the current medications is more consistently successful in treating overactive bladder than the others.   Older medicines seem just as effective as newer ones, but different patients respond to different treatments.  Determining which medication is most effective for an individual patient is often a matter of trial and error.