Having an overactive bladder (OAB) is more than an inconvenience; it can become a chronic condition that disrupts your daily life, work and relationships. Moreover, it can impact your self-image and emotional well-being. Read on to learn more about the causes, symptoms and diagnosis for an overactive bladder.

What Is an Overactive Bladder?

An overactive bladder refers to a group of urinary symptoms associated with a frequent, sudden urge to urinate that may be difficult to control. While it is more common in older adults, it is not considered a normal part of ageing and can affect people of all ages and genders. Sometimes, you can experience it without leakage while others can face challenges with frequency and incontinence.
Although the severity varies, it can still influence your quality of life. The most defining warning signs of an overactive bladder include:

• A strong, sudden urge to urinate that is difficult to ignore.
• Needing to urinate more than 8 times in a 24-hour period.
• Waking up more than once per night to urinate.
• Involuntary and urgent leakage.

How Common is Having an Overactive Bladder?

According to research, there are millions of people globally who are estimated to have overactive bladder symptoms. While it affects both genders, there is still a higher risk for women after childbirth and during menopause. However, in men, it’s common for misdiagnosis as benign prostatic hyperplasia, a common and noncancerous enlargement of the prostate gland leading to various urinary concerns.

What Causes Overactive Bladder?

The detrusor muscle, located in the wall of your bladder, is responsible for emptying the urine contents. However, there are specific risk factors that can lead to abnormalities in this muscle. For instance, you could experience involuntary contractions responsible for the urgent need to urinate. On the other hand, you may have weakened contractions, leading to the inability to empty the bladder.
There are various conditions you may be vulnerable to when there’s a diagnosed dysfunction of the detrusor muscle. Research suggests that conditions such as untreated urinary tract infections, bladder stones and stroke can lead to an overactive bladder. Other main causes can include:

• An enlarged prostate can block the flow of urine and irritate the bladder.
• Childbirth, pelvic surgery, or chronic straining can weaken the muscles that support the bladder and urethra, particularly in women.
• In women, declining oestrogen levels after menopause can thin the bladder lining and affect muscle control. In men, changes in testosterone and age-related changes in prostate size can play a role.
• Lifestyle and dietary triggers such as smoking, alcohol consumption, obesity, artificial sweeteners and carbonated beverages.
• Other health conditions like anxiety, chronic stress and constipation.
• Idiopathic overactive bladder syndrome is a condition without known causes or associations to a diagnosable medical disorder, but still requires treatment and management.

How Is Overactive Bladder Diagnosed?

You might not realise that you require medical attention because overactive bladder symptoms can fluctuate from mild to severe, occasionally or become constant. However, if your symptoms worsen, seek professional help. With an Affinity Health plan, your diagnosis will typically begin with a consultation with a network general practitioner who will refer you to a specialist such as a urologist, and a thorough examination will normally include:

• Medical history to determine the onset and duration of symptoms, fluid intake and diet.
• You might be asked to keep a bladder diary to track the number of times you urinate, episodes of urgency and the amount of urine passed.
• Urine tests can detect any infection and abnormalities.
• A bladder scan or ultrasound determines the amount of urine remaining post-urination. High residual volumes may suggest retention or obstruction.
• Urodynamic testing to assess bladder pressure, capacity, and function during filling and emptying.

Treatment Options

If you have an overactive bladder, you should know that it’s treatable and can be managed with the proper combination of therapies. Early intervention is a proactive way to prevent complications like urinary tract infections, skin irritation from leakage, and mental health decline. These are common treatment options to consider:

1. Lifestyle and Behavioural Changes: Gradually increasing the time between urinations, establishing a urination schedule regardless of urge and including pelvic floor muscle exercises, such as Kegels can help improve the muscles that control urination. Making dietary adjustments and reducing pressure on the bladder through effective weight management can influence significant changes.
2. 2. Medications: If lifestyle changes don’t provide improvements, medications such as Antimuscarinics and Beta-3 adrenergic agonists are prescribed. However, you should note that even though they can be effective, you may experience side effects such as dry mouth, constipation, blurred vision, or elevated blood pressure. Always inform your doctor if you experience side effects that may impact your everyday activities.
3. Advanced Therapies: In rare and severe cases, bladder surgery may be an option to reduce the risk of an overactive bladder. Sometimes, bladder Botulinum toxin (Botox) injections can be administered into the bladder wall to improve muscle function. However, if urine retention occurs, a temporary catheter may be required.
4. Complementary and Supportive Strategies: Your doctor may recommend pelvic floor physiotherapy to strengthen the pelvic floor muscles. Moreover, cognitive behavioural therapy (CBT) can help manage symptoms associated with anxiety or distress. You should also consider support groups to speak with others facing similar challenges and share practical tips.

Having an overactive bladder is common, but it’s also treatable, and manageable. With access to the right medical guidance, support, and self-care tools, it’s entirely possible to take proactive measures to improve your life. Affinity Health‘s Day-to Day and Combined Plans offer access to convenient telehealth consultations and a nationwide network of GPs who can provide a specialist referral if they suspect that you may have an overactive bladder.