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Bruce Robertson, MD, FACS, CPE, AME
Henry Robertson, ATP, CFI
Overactive Bladder
What is Overactive Bladder?
Overactive bladder (OAB) is a term that we use to describe a group of bladder disorders. An overactive bladder will often give you a strong urge to urinate even when your bladder isn’t really full. OAB occurs in both men and women but it seems to be a bit more common in women. It is also more common in older adults especially women after menopause but it is definitely NOT a part of the normal aging process.
How Do I Know if I Have OAB?
Symptoms of OAB and include frequent urination or a constant sensation that you need to urinate when you really don’t. “Urgency” is the hallmark of OAB. In other words, the urge to urinate comes on suddenly and is very strong. Sometimes the urge is strong enough that urine will leak out before you get to the bathroom. Many people with OAB find that they need to urinate several times at night. These symptoms can be severe enough that they interfere with work, daily activities, social activities, sleep, etc. Many people with OAB avoid activities that they would normally enjoy out of fear of embarrassment or not being near a bathroom.
How is OAB Diagnosed?
There are many conditions that can mimic OAB. Bladder infection is probably the most common of these. People with neurologic problems such as stroke, multiple sclerosis, spinal cord injuries, etc. can have bladder symptoms identical to those of OAB. Men with an enlarged prostate often have symptoms similar to OAB. It is, therefore, important that these other problems are not missed.
Urinalysis is almost always necessary to be certain there is no infection. Men and women with signs of neurologic problems may need specialized evaluation. It is often helpful to keep a three-day bladder diary in which you record how much and what you drink, when and how much you urinate and whether or not you have leakage episodes. A physical exam is always important to check the prostate in men and to evaluate the pelvic muscles in women. Sometimes we need to look in the bladder with a tiny scope.
How is OAB Treated?
Fortunately, there are many ways to deal with OAB. The following is a list of the most common approaches:
1. Lifestyle changes including diet, exercise, smoking cessation, weight loss, etc.
2. Avoidance of bladder irritants such as caffeine, alcohol, spicy foods, dark chocolate
3. Behavioral modification such as pelvic floor muscle exercises, biofeedback, bladder retraining (physical therapy for your bladder)
4. Medications to relax the bladder and make it less sensitive
5. Botox injections into the bladder wall
6. Nerve stimulation techniques and, occasionally, acupuncture
7. Surgery if all else fails
What Do I Do if I Think I have OAB?
First, realize that you are not alone and there is nothing to be ashamed of. OAB affects many men and women and is a medical condition that can be treated. You probably know somebody who has OAB (whether they have talked about it or not).
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Second, discuss the problem with your family doctor or provider. She or he may be able to help and you will need to go no further. Many people with OAB are referred to a urologist or choose on their own to see a urologist. The most important thing to remember is that you should feel free to discuss the problem in detail with a knowledgeable healthcare professional.
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We hope that this answers some of your questions about OAB. Call Gallatin Urology (406-551-2306) for an appointment if you need more information or if you are having problems with OAB.