It's not something that people like to talk about in public. It's a private matter. But talking to your doctor about overactive bladder is the first step to managing the condition.
Over 30 million Americans have symptoms of overactive bladder (OAB). The condition is characterized by the strong, sudden urge to urinate, regardless of how much urine is in the bladder. It's caused by the bladder muscles spasming, or contracting inappropriately. It affects both women and men, but they may have different symptoms.
Dr. Pamela Ellsworth is a urologist and co-author of the book, “Questions and Answers About Overactive Bladder.” She told dailyRX that the average individual has symptoms of OAB for three years before seeking treatment.
“Women have the feeling that it's not life threatening. They may be concerned that the only intervention is surgery, or there's nothing they can do – they're just getting older,” Dr. Ellsworth explained. “They lack an understanding of the treatment options. They will downplay their symptoms, or won't come forward in speaking about it. They're often embarrassed about it.”
Dr. Ellsworth wrote her book as a resource for patients who want to understand their condition, and get answers to common questions. She said these days, doctors don't have a lot of time to spend with patients. Knowing the basics about overactive bladder can help you get more comfortable discussing the condition, and when to ask for help.
What should I know about overactive bladder?
Dr. Ellsworth said the most important thing to know is that it's not just you – overactive bladder is a common condition, and it's treatable.
Although OAB affects both men and women, it's more common among females. Women are more likely to have incontinence, while men simply have to go to the bathroom more urgently and frequently. Instead of being able to wait until it's socially appropriate to take a bathroom break, Dr. Ellsworth says, people with OAB are overtaken by an urgency that cannot be delayed.
OAB symptoms may be a sign of a more serious problem, or it might be just overactive bladder. Dr. Ellsworth encourages patients to get a full evaluation in order to rule out serious diseases like bladder cancer, or infections, before treating overactive bladder.
Is it treatable?
Overactive bladder is treatable. “The management of OAB is primarily behavioral and pharmacological,” Dr. Ellsworth said. “Behavioral is looking at factors that exacerbate the symptoms, such as dietary and fluid intake, bowel function, and voiding schedules.”
For example, she said, caffeine can be an bladder irritant and diuretic, responsible for more frequent trips to the bathroom. Some people with OAB take the tactic of not drinking anything – and that makes symptoms worse. Concentrated urine also acts as a bladder irritant.
An easy behavioral treatment is to go to the bathroom on a regular schedule – even if you feel you don't have to. For women, pelvic floor muscle excercises, also called Kegel exercises, can train the bladder to suppress its irregular contractions, and decrease the feeling of urgency. These exercises are repetitive contractions of the pelvic muscles. Modifying your diet and fluid intake can also make a difference in your symptoms.
There are also medications available. “Pharmacologic therapy - drugs, medication - are designed to treat the bladder contractions,” Dr. Ellsworth said. “They work on the physical end. Pharmacological therapy is treating the bladder. But behavioral therapy is treating the person, looking at all the factors that come into play.”
She said drugs are a “quick fix,” but the outcomes can be improved by a combination of both medication and behavioral modifications.
What should I ask my doctor?
If you have overactive bladder, it's likely that you will be managing its symptoms for the rest of your lifetime. “It can wax and wane, but in the vast majority, the symptoms continue over the long term,” Dr. Ellsworth said. That's why it's important to get evaluated and talk to your doctor about the condition, if it bothers you.
She said a common mistake that patients make is not discussing what they want and expect from treatment. Do you expect your symptoms to go away completely, or do you simply hope to find a way to have fewer embarrassing incidents? Doctors may make assumptions about what therapies work best for you, that aren't in line with your needs. So speak to your doctor about your expectations, and what treatment is best for you.
“Patients need to be aware of what are the efficacies of the various therapies, and also the side effects of the therapies,” Dr. Ellsworth said. “Don't be afraid to ask if there are other options.”