urology Over active bladder

Over Active Bladder (OAB) is defined as  “ Urinary  urgency  with or without urge incontinence usually with frequency and  nocturia if there are no infection or any proven other etiology.

The bladder relies on a healthy urinary tract for proper functionalities. The communication pathways also need to be intact between the brain, spinal cord  and the bladder muscles. There could be several conditions affecting the parts of the body and causing the bladder muscle to contract involuntarily and repeatedly.

What are the causes of overactive bladder?
The overactive bladder is generally a result of the involuntary and repeated muscle contractions in the bladder muscles. It might take when the bladder is full or even when it is not. Only  in those cases where the exact cause of this bladder over activity is not know is termed as  OAB.

Causes of Detrusor over activity

  1. Idiopathic Detrusor over activity. There are no identifiable cause of this
  2. Neurogenic detrusor over activity
    • Brain level
      • Stroke
      • Parkinson’s Disease.
      • Brain tumors
      • Traumatic Brain Injury
      •  Multiple Sclerosisa
    • Spinal Cord level
      • Spinal cord Injury
      • Spinal cord tumor
      • Multiple sclerosis.
      • Transverse Myelitis
      • Myelodysplasia
    • Diabetic Neuropathy
  3. Non Neurological conditions
    • Bladder Infection
    • Bladder Outlet Obstruction Like prostate and Stricture of urethra.
    • Bladder Stones
    • Bladder Tumors.

What are the risk factors of overactive bladder?

There are certain risk factors that might increase your chances of experiencing an overactive bladder. Some of these are related to age and gender. Some other are due to life style that can be prevented. The risk factors of overactive bladder include:

  1. Gender - It is more likely for women to feel incontinence than men. Pregnancy, menstruation and the menopause can affect the pelvic floor muscles and hormones in women in a very similar way
  2. Age - Overactive bladder can occur at any age but the risk increases as you become older. Common among peopleof  Type A personality, high position jobs, high tension jobs.
  3. Obesity - If you are packing excess weight, then the bladder is surely carrying extra weight. Thus obesity could lead to conditions that could affect the blood flow and the nerve activity in the bladder

What are the conditions that might trigger an overactive bladder?

The possible triggers that might the symptoms of overactive bladder include:

  • drinking too much alcohol or caffeinated drinks
  • eating acidic foods like citrus fruits or tomatoes, carbonated drinks like cola.
  • constipation
  • not having enough fluids to drink
  • not taking fibrous foods in the diet

Identifying these triggers and avoiding could  help you reduce the symptoms of an overactive bladder.

Treatment

Management of OAB is mainly conservative methods only. OAB is self limmitng. Many time after some years symptoms subside slowly on its own. Some treatment options in OAB are

  1. Avoid excessive consumptions of Caffeine, chocolates, carbonate drinks.
  2. Exercise regularly,  indulge in relaxation like yoga and meditation.
  3. Good  pharmacological treatment are available now. Darifinacin, Solifinacin Mirobegran are available  drungs to treat OAB quite effectively.
  4. Botox injection to bladder can treat OAB. This is used when the medicines are less effective in the treatment. But injections need to be repeated after one years.

Overactive bladder is quite common in women and the symptoms might be similar to other conditions. Diagnosis is mainly by excluding other similar condition. It is  important to seek treatment to improve the situation. Apart form drugs exercise and relaxation has a major to play.

Authored By : Dr. Mahendra Jain

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