An overactive bladder affects millions of individuals around the world. It is a common condition with a collection of urinary symptoms, the most frequent one being a sudden urge to urinate that feels unbearable. Some individuals with the condition experience incontinence and leak urine upon feeling the urge and some may have to go to the bathroom multiple times throughout the day and night. An overactive bladder is often a frustrating condition to live with as it can disturb the flow of work, sleep, social life, and exercise. Before treatment options can be considered, it is important to identify the causes of an overactive bladder.
Internal infections are the most common reason for an overactive bladder, in particular, urinary tract infections, which affect the kidneys, bladder, and tubes running between them (any part of the urinary system). The urinary tract removes excess water and waste from the body and the kidneys formulate urine by filtering the blood and removing surplus water and waste. The fluid then travels to the bladder and the bladder stores it until it is removed by the body. Other symptoms of a urinary tract infection may include a strong and frequent need to urinate, cloudy, strong-smelling or bloody urine, a burning sensation or pain when urinating, nausea, vomiting, and abdominal pain.
Side Effects Of Medication
Many pharmaceutical drugs tend to induce excess urination and are a leading cause of an overactive bladder. Excess urination is an automatic detoxification effect and there are medications that may increase or cause urinary incontinence: diuretics, alpha-blockers for hypertension, antidepressants, narcotic pain relievers, sedatives, and sleeping pills. Certain medications contain diuretics to help rid the body of excess fluid, which makes it easier for the heart to pump. Alpha-blockers help reduce hypertension or high blood pressure, but these drugs also have a diuretic effect. Antidepressants and narcotic pain relievers can prevent the bladder from emptying completely, giving rise to urgency and frequency of urination. Sedatives and sleeping pills can decrease the awareness of the need to urinate.
Pregnancy And Post-Birth
Pregnancy can naturally create the problem of an overactive bladder, which may continue long after the child is born. The amount of strain placed on the bladder during pregnancy and childbirth can result in damage that can take months or even years to recover from. Each woman is different, but a significant number of women experience an overactive bladder during pregnancy and post-birth. An overactive bladder is more common among women who give birth vaginally and for women who have had many children, however, women who give birth by C-section may experience an overactive bladder as susceptibility is also influenced by genetics.
Neurological disabilities are among the top reasons for an overactive bladder, affecting patients with multiple sclerosis and Parkinson's disease. Other disorders that may produce this symptom include syphilis, tumors of the brain or spinal cord, and diabetes. Urinary incontinence can occur when the nerves controlling the muscles of the urinary tract are damaged, resulting in accidental and sometimes incomplete voiding. With incomplete voiding, the risks of urinary tract infections and bladder stone formation increase, as stagnant urine can lead to infections. When the condition is severe, life-threatening kidney failure may result. An overactive bladder due to brain conditions may occur at any age, but seniors are especially prone to it.
Tumors And Cancerous Growths
Cancers near the pelvic area including the prostate cancer, colorectal cancer, urethral cancer, bladder cancer, cervical cancer, and uterine cancer all may increase the risk of an overactive bladder. Cancers and their treatments can cause urinary incontinence or other changes in the body leading to it. Certain cancer treatments may also cause an overactive bladder including radiation therapy, which can cause irritation to the bladder; chemotherapy, which can damage nerves and muscle control over urination; treatments causing early menopause or lowering estrogen levels; and medicines that increase urine production. An overactive bladder can hurt the quality of an individual's life, which is why it's important for them to speak with a doctor about how to treat and manage their condition.
Diabetes patients may experience an overactive bladder as a result of their disease. Diabetes is characterized by an autoimmune attack on the cells in the pancreas responsible for producing insulin. Insulin is a hormone responsible for removing glucose from an individual's blood when it gets too high. Individuals with diabetes have trouble mediating high blood sugar levels. High blood sugar over time can cause nerves around the body to sustain damage. The nerves responsible for the transmission of impulses between the bladder and the brain can become damaged as a result of diabetes.
Damaged nerves can result in misfiring of nerve signals at inappropriate times to the bladder that causes its muscles to contract suddenly. This results in symptoms of frequent urination, urinary urgency, and urge incontinence. Managing blood sugar effectively and making lifestyle changes such as adopting a high fiber diet and maintaining a healthy weight can help treat an overactive bladder from diabetes.
Individuals who have an enlarged prostate may experience an overactive bladder. The prostate gland is a gland in males located between the penis and bladder. The prostate gland is responsible for secreting a specialized fluid that protects and nourishes sperm. As an individual advances in age, their prostate can slowly grow larger in a benign fashion. An individual's prostate can also become enlarged as the result of a more malicious growth such as prostate cancer. Because the urethra runs through the prostate from the bladder to the penis, an enlarged prostate can narrow the urethra. The result of a narrowed urethra in a male is the bladder must use a greater effort to force the urine out of the body.
This malfunction causes the bladder muscle to do what any other muscle does when it is exercised over time, and it becomes stronger and thicker. While this sounds like it would be beneficial, it is actually more problematic because it increases bladder sensitivity. The bladder starts to contract in response to minimal amounts of urine, causing the patient to experience an overactive bladder. Certain medications and surgical procedures can help alleviate the symptoms that result from an enlarged prostate.
Excessive Consumption Of Diuretics
Excessive consumption of diuretics can result in an individual developing an overactive bladder. Diuretics are drugs used primarily to treat high blood pressure and other cardiovascular conditions. These medications work by stimulating the patient's kidneys to discharge an increased quantity of sodium in the urine. Because sodium is the main electrolyte that controls the movement of fluid, the sodium excreted in the urine takes fluids with it. This decreases the fluid levels in the body and increases the urine output. This causes the individual's bladder to fill up faster and void more often.
Excessive use of diuretics over extended durations can considerably overwhelm the patient's bladder muscle and its urine capacity. This mechanism results in an adaptive response by the body where it abnormally triggers the release of urine before it accumulates to the typical amount in healthy individuals when their brain sends signals to the bladder to urinate. Stopping the use of any diuretic medications and performing certain exercises to increase the bladder capacity can help mediate the symptoms that precipitate from this cause of an overactive bladder.
The natural process of aging is a prevalent cause of an overactive bladder in many affected individuals. Older individuals are more likely to experience an overactive bladder due to accumulated damage to the involved nerves and the progression of one or more neurocognitive disorders. These factors interfere with nerve signaling to and from the bladder. Older individuals are also more prone to experiencing a pelvic organ prolapse, reduced estrogen, an enlarged prostate, bladder stones, urinary tract malignancies, problems with the hips, weakened bladder muscles, and obesity. All of these factors can result in the development of an overactive bladder.
Older individuals have a greater likelihood of developing conditions that limit the use of their abdominal and pelvic muscles, which can also cause an overactive bladder. Any structural abnormality of the body that puts excess pressure on an individual's bladder such as skeletal deformities, edema, and numerous others can cause them to develop an overactive bladder. The increased prevalence of physical problems in the body as it ages is the main cause of age-related overactive bladder. Treatment for the underlying medical problems causing the overactive bladder may help alleviate symptoms.
Operations To Treat Incontinence
Individuals who choose to undergo surgical operations to treat incontinence may experience an overactive bladder following the operation. This complication can occur when the procedure causes injury to blood vessels, nerves, or the bladder itself, which can interfere with its nerve signaling and urine capacity. Some operations to treat incontinence involve the installation of a surgical mesh sling. The sling can erode through neighboring tissues in some individuals, which can result in permanent damage to blood vessels, nerves, and the bladder itself. This damage from surgical mesh can cause the affected individual to have new or worsened symptoms of an overactive bladder.
While most anti-incontinence surgical procedures have a relatively high success rate, complications are always possible. It is imperative that all factors are taken into consideration when deciding to undergo surgical treatment for incontinence, including age, health status, symptom severity, lifestyle, medical history, additional problems involving the pelvic and abdominal regions, and the underlying cause of the condition. Careful planning can help minimize the risk of experiencing post-operation complications like an overactive bladder.
Treatment Options For An Overactive Bladder
The most effective treatments depend on the cause, type, length of time, and severity of the overactive bladder. Some options include bladder training (delaying urination, scheduling trips to the toilet, diet and fluid management, and using devices to help improve muscle control), physical therapy such as Kegel exercises and electrical stimulation, medications to help control or relax the bladder muscles, and medical devices. Some tips for helping manage incontinence include limiting the amount of fluid consumed, especially coffee and alcohol; urinating before bed and before any strenuous activity; wearing absorbent pads; losing extra weight, which can add pressure to the bladder; avoiding foods that might irritate the bladder, such as dairy, citrus fruits, chocolate, sugar, tea, and vinegars; and quitting smoking, as nicotine can damage the bladder and cause coughing.