Overactive Bladder Causes and Treatment

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overactive bladder

Overactive bladder (OAB), also known as overactive bladder syndrome, is a condition where there is a frequent urge to urinate to a degree that negatively affects a person’s life. Overactive bladder occurs because the muscles of the bladder start to contract involuntarily even when the volume of urine in your bladder is low. This involuntary contraction creates the urgent need to urinate. More than 40% of people with overactive bladder have incontinence. While about 40% to 70% of urinary incontinence is due to overactive bladder, it is not life-threatening. Most people with the condition have problems for years.

What Causes Overactive Bladder Syndrome?

The cause of overactive bladder is unclear, and indeed there may be multiple causes. The urinary bladder is comprised of nerves, muscles, and connective tissue. The most important muscle in the bladder is the detrusor muscle. In normal circumstances, when the bladder fills with urine, it can stretch to hold the urine. When the volume in the bladder reaches close to 300 cc, the stretch in the wall of the bladder can trigger a nerve response to initiate urination (micturition). This reaction results in loosening of the sphincter in the neck of the bladder (connecting the bladder to the urethra) and contraction of the detrusor muscle so that urination can ensue. This response can be overridden voluntarily by an individual to prevent urination if it is not the right time or place.
It is often associated with over activity of the detrusor urinae muscle, a pattern of bladder muscle contraction observed during urodynamics. It is also possible that the increased contractile nature originates from within the urothelium and lamina propria, and abnormal contractions in this tissue could stimulate dysfunction in the detrusor or whole bladder.
Overactive bladder can result from dysfunction of the nerves or muscles in the bladder, most commonly the dysfunction of the detrusor muscle. In OAB, the detrusor can contract inappropriately regardless of how much urine is stored in the bladder, hence the term detrusor overactivity.

Risk Factors of An Overactive Bladder

The most common risk factor for overactive bladder is increasing age. Approximately 20% of people over the age of 70 report symptoms suggestive of overactive bladder. The following are other common risk factors for overactive bladder:

  • Previous stroke
  • Diabetic neuropathy
  • Multiple sclerosis
  • Parkinson's disease
  • Dementia
  • Spinal cord injury
  • Obesity
  • Multiple pregencies
  • Prostate surgery
  • Previous pelvic surgery

Common conditions such as urinary tract infection, kidney and bladder stones, or bladder tumors can all cause overactivity of the detrusor muscle, resulting in overactive bladder.
Some nervous system conditions can increase the susceptibility to develop overactive bladder. These conditions include diabetic neuropathy, stroke, multiple sclerosis, spinal cord injury, dementia, and Parkinson's disease.

Treatment for an Overactive Bladder

Medication:
Studies have shown that few people get complete relief from overactive bladder drugs and that all available drugs are no more than moderately effective. A typical person with overactive bladder may urinate 12 times per day. Medication may reduce this number by 2-3 and reduce urinary incontinence events by 1-2 per day.
Research literature shows that in alternative medicine, acupuncture has shown some efficacy while reflexology and hypnosis have not. In all cases the strength of evidence is not sufficient to allow fully informed recommendations of treatment. Some behavior modification practices were associated with benefits comparable to any other treatment. The strength of the evidence is insufficient to fully inform choice of these treatments. Some behavior modification practices produced symptom improvements comparable to medications, but the limited evidence available shows no improvement for patients who combine behavior changes with drugs.

Nonpharmacological:

Nonpharmacological methods of treatment includes: lifestyle modification (fluid restriction, avoidance of caffeine), bladder retraining, pelvic floor muscle (PFM) exercises, and timed voiding programs.
Timed voiding is a form of bladder training that uses biofeedback to reduce the frequency of accidents resulting from poor bladder control. This method is aimed at improving the patient’s control over the time, place and frequency of urination. To do this a patient fills in a chart of voiding and leaking. From the patterns that appear in the chart, the patient can plan to empty his or her bladder before he or she would otherwise leak. Through this bladder training exercise, the patient can alter their bladder’s schedule for storing and emptying urine.

Healthy Lifestyle Habits:

In addition to maintaining a healthy weight, there are other lifestyle changes you can make to improve your bladder symptoms. For example:

  • Quit smoking - Cigarette smoke irritates your bladder muscle, and smoker’s cough can lead to urine leakage
  • Choose drinks wisely - Some beverages can improve your bladder symptoms, while others can worsen them. You should regularly consume three to four glasses of non-irritating fluids such as water each day. Avoid acidic or caffeinated beverages, which can worsen your symptoms.
  • Work your bladder muscles. Your bladder muscles can be trained like other muscles in your body. With your doctor’s guidance, you can learn techniques to condition your bladder muscles to hold urine more effectively and decrease feelings of urgency.

Certain foods and drinks can make your symptoms worse if you already have an overactive bladder. Try to avoid or eliminate the following:

  • spicy foods, such as those containing hot peppers or curry
  • citrus fruits and juices, such as orange, tangerine, and grapefruit
  • citrus fruits and juices, such as orange, tangerine, and grapefruit
  • tomatoes/tomato products, including spaghetti sauce and tomato paste
  • coffee and tea, both caffeinated and decaffeinated
  • alcoholic beverages
  • chocolate

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of IncontinenceSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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