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Tuesday, June 10, 2014

Managing Overactive Bladder (OAB)

Posted by Dr Prahallad Panda on 7:21 PM Comments

Fail to postpone the need to urinate, need to urinate more than 8 times per day, Leakage of urine with urge to urinate and need to get up at least twice at night to urinate?
You might be suffering from “Overactive Bladder (OAB)” that comprises urinary urgency, frequency, urge incontinence and nocturia (described above). An overactive bladder is not an illness per say, but rather a term used to describe the above 4 of urinary symptoms.

The first sensation of bladder filling is experienced at a volume of 100 to 150 mL in an adult, and the first desire to void is elicited when the bladder becomes distended with 150 to 250 mL of urine. A person becomes uncomfortably aware of a full bladder when the volume is 350 to 400 ml. An increase in volume to 700 mL creates pain and, often, loss of control.
Overactive bladder is a fairly common condition, which affects about 33 million Americans. This equates to about 30 percent of all men and 40 percent of all women in the United States living with symptoms of an overactive bladder.
It may be a neurological problem or may be that the bladder muscles are overactive to give rise to premature contraction of bladder.
Sometimes people with OAB also have "urgency incontinence." This means that urine leaks after they feel the sudden urge to go. This isn’t the same as "stress urinary incontinence" or "SUI.” Women with SUI leak urine while sneezing, laughing or doing other physical activity.
Common conditions that give rise to frequency, urgency, urge incontinence or nocturia are;
For Women:

• UTI – urinary tract infection

• Fibroids (Myomas) – non-cancerous growths of the uterus

• Cystitis – inflammation of the bladder

• Childbirth – pelvic muscles can become out of sync after childbirth and contract when they shouldn’t

• Idiopathic – cause is unknown

For Men:


• Enlarged prostate

• Bladder Stones

• Bladder Cancer

Therefore, all these serious conditions are to be rules out by your doctor, who may like to order tests like;
  • Post-void residual urine
  • ultrasound scan of your bladder
  • Measuring urine flow rate by uroflowmetry.
  • Testing bladder pressure by Cystometry etc.
After investigations to rule out a definite causes, diagnosis of OAB (Idiopathic) can be made, so to say by method of exclusion.

Medications that relax the bladder can be effective for relieving symptoms of overactive bladder (Idiopathic) and reducing episodes of urge incontinence. These drugs include:

Oxybutynin as a skin patch

Common side effects of most of these drugs include dry eyes and dry mouth, but drinking water to quench thirst can aggravate symptoms of overactive bladder. Constipation — another potential side effect — can decrease bladder capacity, also aggravating symptoms. Extended-release forms of these medications, including the skin patch or gel, may cause fewer side effects.
Other treatment options like surgery, injection of Botox and sacral nerve stimulation are being talked about.
But, in most of the cases reassurance, less intake of coffee & alcohol, avoiding drinking of a lot of fluid after evening and some sedative for good night's sleep may work without having to take the medications.

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