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Overactive Bladder

An abnormally frequent urge to urinate affects millions of people worldwide. This information will help you to understand the condition of an overactive bladder in a better way:


What is an overactive bladder?

Overactive Bladder (OBA) is a condition which causes sudden and frequent urge to urinate and the person suffering from it is often not able to reach the toilet in time to expel the urine voluntarily. The frequency and urge may also change in day and night.

This condition results when the detrusor (smooth) muscle covering the bladder relaxes or contracts with abnormal frequency and after short intervals. Instead of waiting till the bladder is completely filled with urine, the muscles contract prior and lead to frequent urination.


What are the causes of overactive bladder?

The exact cause for the development of overactive bladder is not known yet. However, there are several risk factors and underlying conditions that are identified as being the stimulus for the development of this disorder.

These include:

  • Side effects of medicinal drugs

  • Nerve damage

  • Neurological disorders (Parkinson’s disease, multiple sclerosis, etc)

  • Stroke

Other conditions that are also seen as a result of overactive bladder are UTI (urinary tract infection), and BPH (benign prostatic hyperplasia). These are usually excluded in the diagnostic tests.

Some experts believe that genetic mutation and heredity also plays a part in creating vulnerability for developing overactive bladder. People suffering from stress, depression and ADD (attention deficit disorder) have shown similar symptoms to that of overactive bladder.


How is overactive bladder diagnosed?

Initially overactive bladder is noticeable when the patient maintains a urination diary. It helps to create a log showing details of urination, such as frequency and interval between urination, etc. This is a big help for urologists and doctors when making a precise diagnosis.

A urinalysis tests may be performed to check for infections and blood sugar levels, along with the white blood cells as well as checking the concentration of the urine. Residual urine may also undergo catheterization or ultrasound testing in some cases. At times, the doctor may also recommend cystoscopy or urine cytology of the bladder. Often it is important to perform a pressure test with cystometry (CMG) to check the activity level of the detrusor muscles covering the bladder.

Imaging tests, such as MRI, CT scans and cystogram are rarely required in such cases.


What is the treatment for overactive bladder?

These are the types of treatment effective in treating an overactive bladder:


Medicinal drugs

Medicines that contract or relax the smooth detrusor muscles covering the bladder are helpful in treatment of overactive bladder and urge incontinence. There are several drugs available for this.


Therapies

Behavioral therapies combined with medication have helped to improve the symptoms of overactive bladder significantly. These may be simple exercises (timely urination, biofeedback, etc) to fluid management. Dietary changes are also advised to avoid irritating the bladder. These also include quitting smoking and losing excessive weight if obesity is observed.


Neuro-modulation

Neuro-modulation is used when medicinal drugs and behavioral therapies are unsuccessful in treating the symptoms of overactive bladder and urge incontinence. This involves electrical stimulation of the nerves or part of the skin, rectum or vagina.


Surgical treatment

Surgery for treatment of overactive bladder (augmentation cystoplasty) is advised when the bladder produces too much or too little pressure. It is a major surgical operation which can have potential risk of complications and hence is often the last resort to treat overactive bladder or urge incontinence.

Surgical methods include cutting the nerve supply to the bladder (neurolysis).

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