Overactive Bladder

By /

What Is OAB? 

Overactive bladder is the name for a group of bladder symptoms There are three main symptoms: 

• A feeling that you have to pass urine, urgently. • Usually the need to pass urine often (frequently), day and night (nocturia) • Sometimes incontinence, which means that you leak urine with the “gotta go” feeling

If you feel you “gotta go” eight or more times each day and night, or fear urine will leak, you may have OAB

OAB affects millions of women and men It’s not a normal part of aging It’s a health problem that can last for a long time if it’s not treated Many older men (30%) and women (40%) struggle with OAB symptoms.

What are the Symptoms of OAB? 

  1. Urgency: This is the main symptom of OAB It is a strong (urgent) need to pass urine that can’t be ignored. This “gotta go” feeling makes people afraid they will leak urine if they don’t find a bathroom right away People with OAB may also:
    1. Leak urine: Sometimes OAB causes urine to leak out before getting to the bathroom This is called urgency incontinence Some people may leak just a few drops, while others can have a sudden gush 
    2. Pass urine often: OAB may also cause people to go to the bathroom many times during the day. Experts say that frequent urination is when you have to pass urine more than eight times in 24 hours 
    3. Wake up at night to pass urine: OAB can wake a person from sleep to pass urine more than once a night This is called nocturia

How Can OAB Affect Your Life? 

Without treatment, OAB symptoms can have a negative impact on your life It can be hard to get through the day without many visits to the bathroom

Overactive Bladder Diary 

What is a Bladder Diary? 

A bladder diary is an assessment tool used by you and your health care team to better understand your bladder symptoms. It may help you track a number of things: when and how much fluid you drink, when and how much you pass urine, how often you have that “gotta go” urgency feeling, and when and how much urine you may leak

How to Use a Bladder Diary 

  1. Wake up – Begin writing in your diary when you wake up each day. Take notes throughout the day, and continue until you complete 24 hours 
  2. Note your drinks – Write down what you drink (ie, water, juice, coffee, wine) and how much It is helpful to measure the amount If you are unable to measure your drinks, then it’s of great value to take a good guess about the number of ounces every time you drink something. 
  3. Measure urine – During both the day and night, write down when and how much urine you pass. 
  4. Three days – It’s best to keep a diary for at least three days. A one-day diary may not provide enough information to give a true picture of your bladder condition.
  5. Start tracking – Get started by using the attached Bladder Diary to start tracking. 

Treatment of Overactive Bladder

There are a number of things you can do to manage. OAB Everyone has a different experience with what works best. OAB treatment includes

  1. Lifestyle Changes 
  2. Prescription Medications 
  3. Bladder Botox® Treatments 
  4. Nerve Stimulation (peripheral and central) 
  5. Surgery

Lifestyle Changes 

For OAB treatment, health care providers may first ask a patient to make lifestyle changes These changes may also be called behavioral therapy This could mean you eat different foods, change drinking habits, and pre-plan bathroom visits to feel better

  1. Limit food and drinks that bother the bladder – There are certain foods and drinks known to irritate the bladder of some people You can start by avoiding diuretics – these drinks include caffeine and alcohol and they encourage your body to make more urine. Some foods and drinks that may affect your bladder:
    1. Coffee / caffeine 
    2. Tea 
    3. Alcohol 
    4. Soda and other fizzy drinks 
    5. Some citrus fruits 
    6. Tomato-based foods 
    7. Chocolate (not white chocolate) 
    8. Some spicy foods 
  2. Keep a bladder diary – Writing down when you make trips to the bathroom for a few days can help you understand your body better. This diary may show you things that make symptoms worse.
  3. Double voiding – This is when you empty your bladder twice. This may be helpful for people who have trouble fully emptying their bladder. After you go to the bathroom, you wait a few seconds and then try again.
  4. Delayed voiding – This is when you practice waiting before you pass urine, even when you have to go At first, you wait just a few minutes Gradually, you may be able to wait two to three hours at a time. 
  5. Timed urination – This means you follow a daily bathroom schedule. Instead of going when you feel the urge, you go at set times during the day. You may try to go every two to four hours, whether you feel you have to or not. The goal is to prevent that urgent feeling and to regain control.
  6. Exercises to relax your bladder muscle. You may be familiar with exercises to strengthen your pelvic floor muscles, also called Kegel exercises. A special exercise using those same pelvic floor muscles may help relax your bladder during those “gotta go” moments. “Quick flicks” are when you quickly squeeze and relax your pelvic floor muscles over and over again So, when you feel the urge to go, a number of quick flicks may help control that “gotta go” feeling It helps to be still, relax and focus on just the exercise. Your health care team or a physical therapist can help you learn these exercises. Biofeedback may also help you learn about your bladder. Biofeedback uses computer graphs and sounds to monitor muscle movement. It can help teach you how your pelvic muscles move and how strong they are. 
  7. Avoid constipation. Constipation can put pressure on your bladder and worsen your OAB symptoms By keeping healthy bowel habits, you may be able to prevent constipation and help lessen OAB. 

Prescription Drugs

When lifestyle changes aren’t enough, the next step may be

to take medicine. There are several drug types that can relax the bladder

muscle. These drugs, like anti-muscarinics and beta-3 adrenoceptor agonists, can help stop your bladder from squeezing when it’s not full. Anti-muscarinics and beta-3 adrenoceptor agonists can relax the bladder muscle and increase the amount of urine your bladder can hold and empty. Combination drugs, like using both anti-muscarinics and beta-3 adrenoceptor agonists together may help control OAB when one option alone isn’t working.

ANTICHOLINERGIC DRUGS – Anticholinergic drugs treat OAB by helping the bladder muscle to relax. Common medications include oxybutynin,tolterodine and solifenacin. They work well for the bladder but are also linked to many bothersome side effects such as dry mouth, constipation, blurred vision, and lately, some concern for causing confusion or dementia with longer-term use.

BETA 3 AGONIST – Another medication for OAB is mirabegron. It is not an anticholinergic medication, so it is not linked to any of the side effects described above. It is an alpha-agonist, so works a little differently on the bladder, but in the end has the same effect of getting the bladder to relax. It can cause increases in blood pressure so should be used with caution in patients with hypertension. 

Bladder Botox® Treatment

If lifestyle changes and medicine aren’t working, there are other options. In appropriate patients, a trained urologist or urogynecology & reconstructive pelvic surgery (URPS) specialist can help. They may offer bladder Botox® (onabotulinumtoxin). Botox® works for the bladder by relaxing the muscle of the bladder wall reducing urinary urgency and urge incontinence. It can help the bladder muscles from squeezing too much.

Nerve Stimulation

Another treatment for people who need extra help is nerve stimulation, also called neuromodulation therapy. This type of treatment sends electrical pulses to nerves that share the same path for the bladder. In OAB, the nerve signals

between your bladder and brain do not communicate correctly. These electrical pulses help the brain and the nerves to the bladder communicate so the bladder can

function properly and improve OAB symptoms.

Scroll to Top