Overactive Bladder: Know Everything About It

Overactive bladder is basically a condition in which the person frequently urinates. This health complication has affected people worldwide, including in the United States, but differently. 

Generally, overactive bladder prevalence is determined by its level of severity. Its prevalence is determined as per its severity(frequency of symptoms), such as:-

  • 35.6% of the overall population has an overactive bladder if symptoms occur sometimes.
  • 24.7% of the overall population experience overactive bladder symptoms very often.

Don’t know how but the number is increasing with increasing age, says the US National Library of Medicine National Institutes of Health. 

Despite the fact that an overactive bladder is not a part of the ageing process, it is most commonly found in older adults. However, 1 in 11 United States people experience overactive bladder symptoms.

Furthermore, it is mainly found in people of age 65 years and above, irrespective of gender.

What Is Overactive Bladder?

Overactive bladder is a complication when the bladder becomes overactive, which means the bladder frequently performs its release of urine. Sometimes, it can be sudden. People with overactive bladder usually feel like urinating frequently and may also experience urinary incontinence.

In terms of its psychological effects, people with overactive bladder may also feel isolated and always think of their condition before their social life. But if you know what you are going through and how to deal with it, OAB will not ruin your sleep or sex life. So read the whole article with peace of mind that loosens up for the rest of your life.

Overactive Bladder Symptoms

People with overactive bladder experience the following set of symptoms:-

  • Frequent Urination; usually 8 or more times in 24 hours
  • Uncontrolled sudden urge to urine
  • Urinary incontinence
  • Waking up multiple times during sleep to urinate

Leaving it untreated will promote you to the severe phase of overactive bladder, making your life difficult.

What Causes Overactive Bladder?

Overactive bladder causes will be better understood if you have an idea about the processes involved in urination. So let’s see how normal bladder functions.

Our kidney produces urine that is further stored in the urinary bladder. While urinating, the urine starts to flow from the urinary bladder through a tube called the urethra. Urinary sphincter muscles present at the opening of the urethra regulate the release of urine out of the body. In women, the urethral opening is present just above the vagina, whereas in men, the opening is at the tip of the penis. 

The nerve cells signal the brain to trigger the need to urinate once the bladder fills. While urinating, these nerve cells coordinate with the relaxation of urinary sphincter muscles, making the muscles contract and pushing the urine out.

Now see what must make you suffer from an overactive bladder.

Overactive bladder happens because the bladder muscles start to contract involuntarily even when the bladder has less urine in it. There are other conditions as well that cause such involuntary muscle contraction, creating urgency and need to urinate, such as:-

  • Neurological disorders like stroke and multiple sclerosis.
  • Urinary Tract Infection(UTI)
  • In women, hormonal changes due to menopause
  • Bladder complications, such as tumours or stones
  • Bladder outflow obstructing factors, such as enlarged prostate, constipation
  • As a complication of treatment of incontinence 

Additionally, there are some external factors responsible for the occurrence of overreactive bladder symptoms, such as:-

  • Medications involving a rapid increase in urination as its side effects
  • Excessive consumption of caffeine or alcohol
  • Declining cognitive function due to ageing makes it difficult for your bladder to function properly.
  • Incomplete bladder emptying can lead to overactive bladder symptoms.

What Drugs Can Cause Urinary Retention?

Some groups of medicines contain generic salts that affect urinary sphincter muscles, inflating urine frequency, such as:- 

  • Medicines with anticholinergic properties, such as tricyclic antidepressants
  • Sympathomimetic drugs, like oral decongestants
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Antiarrhythmics, like Disopyramide (Norpace); procainamide (Pronestyl); quinidine
  • Selected Anticholinergics medicines, such as Atropine (Atreza); belladonna alkaloids; dicyclomine (Bentyl); flavoxate (Urispas); glycopyrrolate (Robinul); hyoscyamine (Levsin); oxybutynin (Ditropan); propantheline (Pro-Banthine); scopolamine (Transderm Scop) 
  • Antidepressants, like Amitriptyline (Elavil); amoxapine; doxepin (Sinequan); imipramine (Tofranil); maprotiline (Ludiomil); nortriptyline (Pamelor)
  • Antihypertensives
  • Antiparkinsonian agents
  • Antipsychotics
  • Hormonal agents
  • Sympathomimetics (alpha-adrenergic agents & beta-adrenergic agents)

Can Stress Cause Overactive Bladder?

Stress, anxiety, and depression have been found associated with the development of an overactive bladder and urinary incontinence. For example, a study suggests that 1.5 – 2 fold increases increased the risk of developing urinary incontinence. It involved 16,000 women having anxiety or depression symptoms at baseline.

The exact cause is still unknown, but as per the scientists, there must be two major reasons:-

  • Stress increases the sensitivity of the nervous system. Every one of us experiences the same, but basic reflexes like bladder voiding can stimulate very easily during stress for people with overactive bladder. Consequently, it becomes difficult for such people to handle stress.

Now you can connect why you feel urinating during the last minutes of your exam or any other pressure-building situations.

  • Secondly, anxiety and depression cause muscle tension, affecting the bladder muscles that increase the urge to urinate. Additionally, anxiety and depression are also related to nocturia which is one of the causes of an overactive bladder. 

Also Read : Different effective ways to handle stress, anxiety, depression.

How Does Caffeine Affect The Urinary System?

Caffeine at 4.5mg per kg causes diuresis and decreases the threshold of sensation at the filling phase. This consequently increases the flow rate and voided volume. Hence, caffeine promotes early urgency and increases the frequency of urination. Therefore, people with lower urinary tract symptoms are asked to avoid consuming caffeine.

How Do I Stop Urinating At Night?

A combination of medication and therapies are basically used to treat overactive bladder.

Behavioural therapies: The frontline treatment prescribed for people with overactive bladder is often effective with no side effects. It is further classified as:-

  • Pelvic floor muscle exercise(Kegel exercise): It helps build muscles under the uterus in women and strengthens the pelvic floor muscles in men, which consequently supports the bladder and bowel in both genders. Kegel exercise works on muscle building in both genders. This exercise helps both men and women with urine leakage or bowel control and affects sexual function as well.

The need for the kegel exercise increases with the following conditions:-

  • As you get older
  • Overweight
  • After pregnancy and childbirth
  • After gynecologic surgery in women and prostate surgery in men
  • People with weak sensory nerves of the genital area(overreactive bladder, UTI, urinary incontinence)

The good thing about the kegel exercise, it is easily accessible. Read more about it here.

  • Biofeedback: It is a medical procedure when electrical sensors are placed to measure and receive information about your body. Based on the information, the doctor will help you know what things need to be done to make necessary changes in your body, such as strengthening your pelvic muscles. This will help you at the time of emergency.
  • Healthy Weight: Obesity is the worst health complication. Do you know why? It opens doors for almost every popular deadly disease, dysfunctions, and many more; think of it once! If you are overweight and having overreactive symptoms, immediately work on your weight. This will help you improve your condition.
  • Schedule a toilet timing: Setting a fixed time to go to the toilet will help your body to adapt the same. This will help you maintain a tract of your urination and also reduces the risk of sudden urination.
  • Intermittent catheterization: The major problem with overactive bladder patients is difficulty emptying the bladder completely. Using a catheter periodically can help in emptying the bladder completely, thereby avoiding uncertain or frequent urination. Consult your doctor for this approach, you should not do this on your own.
  • Absorbent pads: Another way to deal with overactive bladder is to wear absorbent pads or other clothes that can help you avoid being embarrassed. You don’t have to worry much about it because absorbent pads are now available in multiple sizes as per people’s convenience.
  • Bladder training involves training your muscles to delay passing the urine when you feel the urge to urinate. Try beginning with a small delay interval such as 20 minutes followed by 40 minutes, then 80 minutes, and so on. Bladder training means being able to tighten your bladder by working on pelvic floor muscles.

These were the natural ways of treating overactive bladder. Apart from this, there are overactive bladder medications as well that can help you with this complication.

What Is The Best Medicine For Overactive Bladder?

Some medicines relax the bladder and help in relieving overactive bladder symptoms. Therefore, women with OAB prefer having vaginal therapy medicines that help them strengthen the muscles and tissues of the urethra and vaginal area. Such medicines include:-

  • Tolterodine(Detrol)
  • Oxybutynin(Ditropan XL, Oxytrol, or Gelnique)
  • Trospium
  • Solifenacin (Vesicare)
  • Darifenacin (Enablex)
  • Fesoterodine (Toviaz)
  • Mirabegron (Myrbetriq)

These medications come with mild side effects, such as dry eyes and mouth, but drinking water to quench thirst will aggravate overactive bladder symptoms. Another one is constipation which can aggregate your bladder symptoms. An extended-release form of such medicines may lead to skin patches or fewer side effects.

Therefore, doctors usually recommend sipping a small amount of water at a small interval of time rather than drinking a glass of water as a whole. To overcome such side effects, you can keep some sugar in your mouth. In order to deal with constipation, you will be asked to consume food rich in fibre or use stool softeners.

Injection To Be Used

An injection containing OnabotulinumtoxinA is used in overactive bladder treatment. It is a protein from the bacteria causing botulism illness. The protein is also known as Botox. It is used by directly injecting it into the bladder tissues because the protein relaxes the bladder muscles, decreasing the risk of involuntary contraction of the bladder.

Some studies have shown that the protein may also be used for severe urge incontinence. However, it has a temporary effect on the overactive bladder for six months; therefore, repeat injections are essential.

Urinary tract infection(UTI) and urinary retention are the possible side effects of this injecting protein. People treated with Botox treatments have to catheterize themselves if urinary retention occurs.

Nerve Stimulation 

Involuntary muscle contraction may also occur due to nerve inflammation; therefore, regulating the nerve impulses will help improve overactive bladder symptoms. A nerve stimulation process involves placing a thin wire close to the sacral nerves responsible for carrying signals to the bladder.

Such an invasive procedure is often done with a trial of a temporary wire implanted under the skin in the lower back. In some cases, the doctor may follow advanced procedures, which include implantation of permanent electrodes, and a longer trial is performed.

The doctor will use a handheld device connected to the wire in order to deliver electrical impulses to the bladder, just like pacemaker implantation. 

Percutaneous Tibial Nerve Stimulation (PTNS)

Basically, PTNS treats overactive bladder the same way as nerve stimulation, but the procedure is a bit different. PTNS involves using a thin needle placed through the skin near your ankles to send electrical stimulation from legs to your spin through nerves, connecting the nerves that control the bladder. 

The PTNS treatment is performed for a period of 12 weeks, in which the treatment will be performed once a week. What else do you need in extra? You will need a maintenance plan for a period of every three to four weeks to lower the risk of overactive bladder symptoms.

Surgery

Surgery is the last option that doctors will recommend to every overactive bladder. It is meant only for patients with severe overactive bladder symptoms. The fundamental motive behind the surgery is to improve the bladder’s ability to store urine and reduces pressure in the bladder. 

  • Surgery to increase bladder capacity: This procedure involves using pieces of your bowel to replace a portion of your bladder. It is used only in cases of severe urge incontinence when all other treatment plans fail to be effective.

People undergoing such surgery need to use a catheter intermittently for a lifetime to empty their bladder.

  • Bladder removal: It is the second type of surgery in which the complete bladder is replaced with a surgically constructing replacement bladder(neobladder); an opening in the body attached to a bag on the skin to collect urine.

What Foods Soothe The Bladder?

People with overactive bladders often have a problem choosing food as some foods help you resolve your condition, and some can make your symptoms worse. We will be discussing both categories.

Fruits

  • Bananas
  • Apples
  • Grapes
  • Coconut
  • Watermelon
  • Strawberries
  • Blackberries

Vegetables

  • Asparagus
  • Broccoli
  • Cucumbers
  • Kale
  • Carrots
  • Celery
  • Lettuce
  • Peppers

Try including food items rich in fibre as it prevents constipation, putting additional pressure on the bladder. Such foods are:-

  • Lentils
  • Beans
  • Fish
  • Raspberries
  • Chicken
  • Artichoke
  • Barley
  • Bran
  • Tofu
  • Oats
  • Eggs
  • Almonds

Additionally, you should also know about foods that can worsen your overactive bladder symptoms, such as:-

  • Honey
  • Chocolate
  • Raw onion
  • Citrus fruit
  • Spicy foods
  • Alcoholic drinks
  • Sports drinks, such as Gatorade
  • Foods containing sugar or sugar substitutes
  • Carbonated beverages, such as sparkling water
  • Caffeinated beverages, such as coffee and tea
  • Foods containing artificial flavourings and preservatives
  • Tomatoes and tomato-based products, including ketchup, tomato sauce, and chilli

It is not necessary to eliminate these food items completely, but yes try consuming less. 

References:-

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Janet Fudge

Janet Fudge writes on general health topics for CheapMedicineShop.com. She holds a post-graduate diploma in Public Health with a major in epidemiology. During the outbreak of COVID-19, Janet actively volunteered in vaccination drives throughout the state of Iowa. She lives in Iowa with her husband and two children.