Conditions, Overactive Bladder

What is Overactive Bladder?

What is Overactive Bladder (OAB)?

Overactive bladder (OAB) is not a condition as such but rather a group of urinary symptoms defined by a problem with bladder storage where the bladder muscle (detrusor) contracts too often or spontaneously and involuntarily. It often includes, and is therefore closely related to, incontinence.

There is a reported incidence of OAB ranging between 12-17% in Europe alone and a suggested 1 in 6 people is suffering from symptoms in the UK. The incidence of OAB increases with age but should not be accepted as a normal part of the ageing process.

The symptoms of OAB are typically:

  • Urinary urgency (a sudden, strong need to pass urine)
  • Urgency incontinence (the sudden need to pass urine before reaching a toilet, leaking urine)
  • Urinary frequency (the need to pass urine more than 8 times per day)
  • Nocturnia (needing to go to the toilet more than once at night)
  • Bed-wetting (Nocturnal Enuresis)
  • Leaking urine during sex (coital incontinence)

The causes of overactive bladder

No one single cause has been identified for OAB. Typically, the causes are multi-factorial. They can include:

  • Infection of the bladder and/or kidneys (cystitis, UTI)
  • Interstitial cystitis (chronic inflammation of the bladder wall)
  • Neurogenic conditions such as Parkinson’s, Stroke or Multiple Sclerosis
  • Nervous system dysfunction
  • Excess intake of stimulants such as caffeine and alcohol
  • Medication side-effects
  • Bladder obstruction
  • Bladder muscle (detrusor) over-activity related to a neurologic or muscular cause
  • Spinal cord injury
  • Certain foods
  • Diabetes
  • Vaginitis
  • Stress

How is overactive bladder diagnosed?

A diagnosis is usually based on a complete history, a physical examination and urinalysis (urine flow and capacity). It is also a diagnosis of exclusion.

Orthodox treatments for overactive bladder

  • OAB is treated in different ways. Typical treatments include:
  • Anticholinergic drugs
  • Bladder botulinum toxin injections
  • Percutaneous tibial nerve stimulation
  • Sacral neuromodulation
  • Desmopressin
  • Botox
  • Betmiga (Mirabegron)
  • Reduction of stimulants
  • Pelvic floor exercises
  • Bladder retraining
  • Surgery

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