Overactive Bladder (OAB)
The most common symptom of OAB is a sudden urge to urinate that you can’t control. Some people will leak urine when they feel the urge. As many as 30% of men and 40% of women in the United States live with OAB symptoms.
What are the Symptoms of OAB?
- Leaking urine/incontinence
- Urinate frequently
- Waking up at night to urinate/nocturia
- Urinating small amounts
What Are the Causes of OAB?
How the Urinary Tract Works
The bladder and kidneys are part of the urinary system the organs in our bodies that produce, store and pass urine. Urine is stored in the bladder.
Once you are ready to urinate, the brain sends a signal to the bladder. Then the bladder muscles squeeze (or “contract”). This forces the urine out through the urethra, the tube that carries urine from your body.
OAB can be caused by the nerve signals between your bladder and brain telling your bladder to empty even when it isn’t full. OAB can also be the result of your bladder muscles being too active. Then your bladder muscles contract to pass urine before your bladder is full, and that causes a sudden, strong need to urinate. We call this “urgency.”
What Are the Risk Factors for OAB?
- Women who have gone through menopause
- Men who have had prostate problems
- People with diseases that affect the brain or spinal cord (stroke, multiple sclerosis)
How is OAB Diagnosed?
You may be asked to keep a bladder diary, where you will note how often you go to the bathroom and any time you leak urine.
- Urine culture: test for infection or blood.
- Bladder scan: office ultrasound that shows how much urine is still in the bladder after you go to the bathroom.
- Cystoscopy: office procedure using a small camera to view the inside of the bladder.
- Urodynamic testing: office procedure to see how well your lower urinary tract stores and releases urine.
- Symptom Questionnaire: written quiz to ask questions about your bladder problems and what causes you the most bother.
What Treatments are Available for OAB?
- Non-surgical therapy
- Lifestyle changes: limit food/drinks that may irritate the bladder
- Medications: aimed to decrease the bladder contractions
- Bladder training: double-voiding and timed voiding
- Tibial nerve stimulation: indirectly stimulate and retrain the nerves controlling the bladder
- Surgical Therapy
- (1) Botox bladder injection – Relaxes the bladder, may last up to 9 months
- (2) Sacral nerve stimulation – Directly stimulate the nerves controlling the bladder