With overactive bladder, you have many strong,
sudden urges to urinate during the day and night. You can get these urges even
when you have only a little bit of urine in your bladder. You may not be able
to hold your urine until you get to the bathroom. This can lead to urine
Overactive bladder is very
common in older adults. Both men and women can have it, but it's more common in
Overactive bladder is a kind of
urge incontinence. But not everyone with overactive
bladder leaks urine.
Even without incontinence, overactive
bladder can make it hard to do the things you enjoy. The need to drop
everything and race to the bathroom can disrupt your life. And if you leak,
even if it's only a little bit, it can be embarrassing.
Overactive bladder can cause other problems too. Hurrying to the bathroom
can lead to falls and broken bones. Overactive bladder can also cause sleeping problems,
urinary tract infections.
are too shy to talk about their bladder problems. But overactive bladder can
get better with treatment. Don't be afraid to talk with your doctor about how
to control your overactive bladder.
Overactive bladder is caused by an
overactive muscle in the bladder that pushes urine out. There are many things
that can make this muscle overactive. It can be caused by a bladder infection,
stress, or another medical problem. Some brain problems, such as
Parkinson's disease or a
stroke, can also lead to overactive bladder. But in
many cases, doctors don't know what causes it.
Some medicines can
cause overactive bladder. Talk with your doctor about the medicines you're
taking to find out if they could affect your bladder. But don't stop taking
your medicine without talking to your doctor first.
The main symptoms of
overactive bladder are:
You may have some or all of these symptoms.
Your doctor will do a physical exam. He or she will ask what kinds of
fluids you drink and how much. Your doctor will also want to know how often you
urinate, how much, and if you leak. It may help to write down these things in a bladder diary(What is a PDF document?) for
3 or 4 days before you see your doctor.
Your doctor probably will
also do a few tests, such as:
You may have more tests if your doctor thinks your symptoms
could be caused by other problems, such as
The first step in treatment will be to try
some things at home, such as urinating at scheduled times.
This is called bladder retraining.
You can also do special exercises called
Kegels to make your pelvic muscles stronger. These
muscles control the flow of urine. Doing these exercises can improve some
bladder problems. It may help to work with a
physical therapist who has special training in pelvic
There are other changes you can make that can
Acupuncture may help with overactive bladder. It has been shown to help some women as much as medicine.1
If your symptoms really bother you or affect your quality of life, your doctor may suggest that you try medicine along with bladder training and exercises. Medicines are used most often to help control overactive bladder. These medicines do have some annoying side effects like dry mouth and constipation. Because of this, a lot of people don't like to take them. You may decide that bladder training and exercises control your overactive bladder enough. Medicines used to treat overactive bladder are the same for men and women.
If you have severe overactive bladder or severe urge incontinence that hasn't been controlled by exercises or medicine, you may be able to try other treatments. These include magnetic or electrical stimulation. But these treatments aren't usually tried unless other treatments haven't worked.
Botulinum toxin (Botox) may be used in people with nervous system diseases or problems (such as multiple sclerosis or a spinal cord injury) to stop bladder contractions that cause severe urge incontinence. But Botox will only be considered if other treatments haven't worked. Botox can cause serious side effects, including not being able to urinate at all.
The American Urogynecologic Society (AUGS) is the
premier society dedicated to research and education in urogynecology and in the
detection, prevention, and treatment of female lower urinary tract disorders
and pelvic floor disorders.
UrologyHealth.org is a website written by urologists
for patients. Visitors can find specific topics by using the "search"
The website provides information about adult and
pediatric urologic topics, including kidney, bladder, and prostate conditions.
You can find a urologist, sign up for a free quarterly newsletter, or click on
the Urology A–Z page to find materials about urologic problems.
NAFC is a nonprofit national organization with a mission
of consumer advocacy, education of the public, and information dissemination
through collaboration and networking for the benefit of those with urinary
incontinence. NAFC's booklet "Your Personal Guide to Bladder Health" can be
ordered on the NAFC website.
The National Kidney and Urologic Diseases Information
Clearinghouse (NKUDIC) provides information about diseases of the
kidneys and urologic system to people with these problems and to
their families, to health professionals, and to the public. NKUDIC answers
inquiries; develops, reviews, and distributes publications; and works closely
with professional and patient groups and government agencies to
coordinate resources about kidney and urologic diseases.
NKUDIC, a federal agency, is a service of the National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is part
of the National Institutes of Health under the U.S. Department of Health and
CitationsHartmann KE, et al. (2009). Treatment of Overactive Bladder in Women. Evidence Report/Technology Assessment No. 187 (AHRQ Publication No. 09-E017). Available online: http://www.ahrq.gov/clinic/tp/bladdertp.htm.Other Works ConsultedLentz GM (2007). Physiology of micturition, diagnosis of voiding dysfunction, and incontinence: Surgical and nonsurgical treatment. In VL Katz et al., eds., Comprehensive Gynecology, 5th ed., pp. 537–568. Philadelphia: Mosby Elsevier.Naumann M, et al. (2008). Assessment: Botulinum neurotoxin in the treatment of autonomic disorders and pain (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 70(19): 1707–1714.
September 11, 2012
E. Gregory Thompson, MD - Internal Medicine & Avery L. Seifert, MD - Urology
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