Do you think you suffer from overactive bladder (OAB)? Only your doctor can provide you with an accurate medical diagnosis. In preparation for your next doctor's visit, it may help to answer a few simple questions (check all that apply):
You answered "yes" to any of the above questions, you may be suffering from overactive bladder. Speak to your healthcare professional about your symptoms, so that you can be properly diagnosed, rule out other medical conditions, and help you decide the best treatment approach.
Keep in mind that working with your healthcare professional will go a long way in managing your overactive bladder symptoms successfully.
What you can do right away is to learn more about the causes of, and best treatment options for an overactive bladder. Once diagnosed, you should, and most importantly, follow the treatment routine that you and your doctor have agreed upon. Just remember that an overactive bladder can be effectively treated and you can look forward to relief from your overactive bladder symptoms and regaining full control of your life!
You do not show symptoms of having an overactive bladder.
About overactive bladder (OAB)
What is overactive bladder (OAB)?
Overactive bladder (OAB) is a chronic medical condition that is marked by the sudden and sometimes uncomfortable need to urinate. This can occur at any time during the day or night, and it may or may not result in the leakage of urine.
Overactive bladder occurs when the bladder's smooth muscle, known as the detrusor muscle, squeezes while the bladder is still filling instead of when it is completely full. When this happens, signals are sent to the brain resulting in the urge to urinate.
This urgency sometimes leads to more trips to the bathroom than normal and for some people, an involuntary loss of urine. Overactive bladder can be both frustrating and embarrassing.
What are the symptoms of an overactive bladder?
Overactive bladder is composed of the following four symptoms:
Urgency: A sudden and compelling desire to urinate.
Frequency: The need to urinate more often than usual during the day or night.
Nocturia: Waking up at night one or more times to urinate.
Urge urinary incontinence: The involuntary leakage of urine.
Leakage of urine caused by physical activity, laughing, sneezing or coughing, is often confused with overactive bladder. This is actually a separate condition called stress urinary incontinence (SUI).
What causes an overactive bladder?
There are various underlying risk factors that can contribute to an overactive bladder condition. Some risk factors are common and may include: urinary tract infections; side effects of medications; diabetes mellitus; estrogen deficiency and excess intake of caffeine and alcohol. Others are more severe and less common, such as: nerve damage caused by spinal cord lesions; neurological disease (e.g. Multiple Sclerosis, Parkinson's disease, etc.), stroke, and a blocked urethra due to enlarged prostate.
Who does overactive bladder affect?
You will probably be relieved to know that you are not alone - between 12 to 18 per cent of Canadians suffer from overactive bladder. Approximately two thirds of sufferers have dry overactive bladder (overactive bladder without urge incontinence), while the remaining one third have wet overactive bladder (overactive bladder with urge incontinence). Even though overactive bladder affects all ages, it tends to be increasingly common with age. Both men and women are equally at risk of developing overactive bladder. However, women are more likely than men to discuss their condition and seek treatment.
Are women more likely to develop an
overactive bladder than men?
Overactive bladder is just as common in men as it is in women. However, women are more likely than men to discuss their condition and seek treatment.
Can pregnancy and childbirth affect bladder control?
Yes, some women suffer from stress incontinence after childbirth, but generally regain bladder control within six weeks. Unfortunately
some women may not regain bladder control in which
case treatment is required.
How is overactive bladder diagnosed?
Overactive bladder is a difficult and embarrassing condition to talk about. However, it is a very real situation. Give yourself permission to speak to your doctor about the symptoms you experience and how this affects your life. It is up to you to start the conversation.
Your physician will begin with an initial assessment of your symptoms and ask questions about how overactive bladder affects your daily life. He/she will take a detailed medical history and conduct a physical exam, including a pelvic examination. Urine and blood tests may be conducted to rule out infection or other diseases.
How does an overactive bladder affect
While overactive bladder is not a life-threatening condition, it can be emotionally distressing and they can have a negative effect on your daily routine and quality of life. For example, you may experience:
- Reduced social activity: You may not want to go out as much or stop doing things you enjoy.
- Anxiety: You may often worry about having a wetting accident.
- Sleep disturbances: You may find yourself getting up frequently during the night to go to the bathroom.
- Skin rashes and skin tears: These problems can occur due to frequent wetting accidents and over-washing with soap and water to prevent odour.
- Increased risk of falls and fractures: The risk of injury and accidents can increase when rushing to the bathroom, particularly at night.
- Work-related issues: Overactive bladder can negatively affect your productivity at work as well as cause embarrassment.
What impact does overactive bladder
have on sufferers?
Other than the obvious physical symptoms, overactive bladder can profoundly affect a person's quality of life. People with an overactive bladder often cope with the physical symptoms by:
•Mapping out bathroom locations to ensure they know where a bathroom is at all times;
• Voiding frequently to avoid leakage episodes;
• Reducing fluid intake;
• Wearing adult incontinence pads, diapers, or sanitary protection;
It is not uncommon for people with an overactive bladder to stop physical or public activities altogether and put their lives on hold. For instance, some individuals will develop sexual dysfunction.
What is the difference between overactive
bladder and incontinence?
While people often refer to 'overactive bladder' and 'incontinence' as the same thing, it is important to understand that they are two different conditions. Incontinence is a general term defined as the accidental, involuntary or unwanted leakage of urine. Urinary incontinence can develop at any age, but as we age, it can become more common because of changes in the body and illness that affect bladder function. While leakage can be a symptom of an overactive bladder, not everyone has this symptom. There are also various forms of incontinence, such as:
• Stress urinary incontinence: Involuntary leakage caused by effort or exertion, such as sneezing or coughing.
• Urge incontinence: Involuntary leakage accompanied by or preceded by urgency.
• Mixed/Combination incontinence: combination of stress and
Is there a link between overactive bladder
and other health problems?
Although overactive bladder is not directly linked to other health problems, individuals with overactive bladder may suffer from other health issues. Some of these include fibromyalgia, irritable bowel syndrome, feeding disturbances, depression, anxiety and attention deficit hyperactivity disorder (ADHD).
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What is the difference between overactive
bladder and urinary tract infection (UTI)?
Overactive bladder is a chronic medical condition characterized by urgency - the sudden and sometimes uncomfortable need to urinate, which is difficult to delay. This can occur at any time during the day or night, and may or may not result in leaking of urine.
A urinary tract infection (UTI) is an infection of the bladder
or the kidneys.
While both overactive bladder and UTI sufferers experience a strong and persistent urge to urinate, the difference is that overactive bladder is a chronic medical condition and a UTI is generally an acute and uncomfortable infection that is curable with a course of antibiotics.
Treatment for overactive bladder and a UTI is different. For patients experiencing symptoms of a UTI, the recommended first-line treatment is a course of antibiotics. Treatment options for overactive bladder may include lifestyle and behavioural changes, exercise, and if required, medications.
How does a person manage an overactive bladder?
Overactive bladder is a condition that can be effectively managed and symptoms can be significantly reduced. There are different options available to manage an overactive bladder and these vary from person to person.
Making lifestyle changes is generally the first step in treating an overactive bladder because it is non-invasive, poses little threat of side effects, and often provides positive outcomes. The aim of this type of treatment is to educate patients on how to improve their overactive bladder symptoms. Behaviour therapiesy, if performed correctly and adhered to, have been shown to successfully reduce overactive bladder symptoms. A specialized health professional such as a nurse continence advisor or a uro-physio therapist is able to provide these therapies. Behavioural therapiesy and modifications which have been found to positively improve the symptoms of an overactive
Diet and fluid management
• Reducing intake of caffeine, including coffee, tea and soft drinks
• Limiting intake of alcohol that can interfere with bladder control
• Maintaining and drinking 'bladder friendly' liquids including water, apple or grape juice
• Stopping or reducing smoking
• Weight reduction
• Bladder management and training - this involves scheduled toileting to gradually increase the length of time between bathroom visits
• Limit fluids 2-3 hours before going to sleep
Pelvic Floor Exercises
• Kegel exercises (pelvic floor exercises) to increase your bladder strength and endurance
Drug therapy options
• Overactive bladder medications are commonly used to treat symptoms such as the "urge to go" resulting in less urgency, less need to use the bathroom and fewer accidents
• It is rare to have surgery to correct an overactive bladder. This option would only be considered after less invasive options have been explored. The main goal of surgery would be to improve severe overactive bladder symptoms.
• In patients where overactive bladder symptoms cause severe disruption to their quality of life and who have not responded to behavioural therapy and medication, neuromodulation may be used. This is a surgical procedure that involves the implantation of an electronic device into the lower part of the spine to regulate the nerves that control the bladder, sphincter, and pelvic muscles.
• Surgery, including radiofrequency bladder neck suspension and newer minimally invasive procedures may be an option for some patients who experience stress urinary incontinence. It is important to determine whether you are experiencing OAB or stress urinary incontinence.
I have heard about Kegel exercises — can that
help with an overactive bladder?
Bladder control depends on how well all of your muscles are working together: the bladder muscle should be relaxed and the pelvic floor muscles should be tight. Exercises that strengthen pelvic floor muscles can help hold urine inside the bladder, preventing leakage. These types of exercises are commonly called "Kegel" or pelvic floor muscle exercises, named after the doctor who developed them.
The aim of Kegel exercises (also known as Kegels) is to strengthen the pelvic muscles that support your bladder. If the muscles of the pelvic floor are weak, the urethra cannot be completely closed and
urine may leak.
Strengthening this muscle group allows the urethra to be properly closed, keeping urine in.
Kegel exercises can be very helpful in reducing symptoms of an overactive bladder and stress incontinence.
Many people think that the only way to relieve the uncomfortable sudden feeling of urgency is to empty the bladder, but this is not necessarily true. "Urges" can come and go without emptying the bladder. An "urge" is a message telling you that eventually you will need to urinate.
In someone with an overactive bladder, the "urge" may be a false message that you need to go right away. "Urges", however, do not need to be commands. They should function as an early warning system, getting you ready to find a place to urinate.
Learning to do Kegel exercises can help with symptoms such as the "urge" to go. One example is constricting your pelvic floor muscles for 5 seconds at a time, then relaxing for 5 seconds; repeating at least three sets of 10 repetitions a day. Kegel exercises need to be practiced consistently to become very effective.
What is biofeedback therapy?
"Biofeedback" therapy is a procedure typically performed by a healthcare professional in a hospital or medical clinic. This procedure requires placing electrodes:
• In the vagina of female patients,
• In the anus of male patients, or
• On the skin in the perineal area (the area between the anus and genital organs)
These electrodes, which are connected to a monitor, are able to read the activity of the pelvic muscles while you perform Kegel exercises. Watching the monitor while performing Kegel exercises will enable you to experience what it feels like when you are contracting the pelvic muscles correctly, and will show you how long the contractions are held.
Lifestyle management for OAB
I constantly have to urinate — how can I travel if I have an overactive bladder?
Planning out locations of bathrooms is quite common for people with an overactive bladder. There are a number of helpful tips that you can discuss with your doctor, such as planning out your bathroom stops, diet and fluid management, and learning how to do Kegel exercises (contracting your urinary or pelvic muscles to suppress the urge to urinate). Medications may also be helpful for some people when traveling, to relax the bladder and decrease the sense of urgency.
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Can I still exercise if I have an overactive bladder?
Regular exercise and physical activity is a good idea for everyone, and can be especially beneficial for people with an overactive bladder! Kegel exercises (also known as Kegels) can help to strengthen the pelvic muscles, and are recommended for people who have been diagnosed with an overactive bladder. In addition, simple exercises such as walking can improve your physical, emotional and mental health, as well as your outlook on life.
What can I do to minimize symptoms of overactive bladder during sexual intercourse?
This is a common and embarrassing problem for overactive bladder patients. To reduce your overactive bladder symptoms during intercourse, it may help to first empty your bladder. It is important to speak to your doctor about your concerns.
Dr. Jane Schulz
Urogynecologist, Royal Alexandra Hospital
Dr. Jane Schulz is a urogynecologist at the Royal Alexandra Hospital, Edmonton and an Associate Professor with the Department of Obstetrics and Gynecology at…READ MORE
Dr. Jane Schulz is a urogynecologist at the Royal Alexandra Hospital, Edmonton and an Associate Professor with the Department of Obstetrics and Gynecology at the University of Alberta. In this setting, Dr. Schulz has a large clinical practice and is involved in the ongoing teaching of medical students, residents, physicians in the community, and allied health professionals. She also coordinated the Student Internship Program at the Royal Alexandra Hospital for two years and is the Resident Research Director. Dr. Schulz has published numerous scientific articles and authored four book chapters in medical texts. Actively involved in ongoing clinical research, her findings have been presented at national and international scientific meetings. Her special interests include urinary incontinence, pelvic organ prolapse, prevention of pelvic floor dysfunction and the role of collagen in pelvic floor dysfunction.CLOSE
Physiotherapist, Royal Alexandra Hospital
Dianna MacDonald is a senior practice physiotherapist for Women's Health, Newborn Medicine and Pediatrics at the Royal Alexandra Hospital, and is an Associate Clinical…READ MORE
Dianna MacDonald is a senior practice physiotherapist for Women's Health, Newborn Medicine and Pediatrics at the Royal Alexandra Hospital, and is an Associate Clinical Professor, Department of Rehabilitation Medicine, University of Alberta. She works as a member of a multi-disciplinary out-patient clinic that treats incontinence and pelvic pain in women and men. Actively involved in education, Dianna has participated in numerous courses, workshops as well as national and international conferences. She is the author of "In Control Again", a patient workbook addressing re-education of the pelvic floor. She has also contributed to public education and awareness of incontinence and menopause and has co-produced a video titled "Electrical Stimulation and the Treatment of Incontinence".CLOSE
Dr. Lesley Carr
Urologist, Sunnybrook Health Sciences Centre
Dr. Lesley Carr received her medical degree from the University of Toronto and has been a consultant staff urologist since 1996 at Sunnybrook Health Sciences…READ MORE
Dr. Lesley Carr received her medical degree from the University of Toronto and has been a consultant staff urologist since 1996 at Sunnybrook Health Sciences Centre. She is also an Assistant Professor, Department of Surgery at the University of Toronto. From 2001 to 2004, Dr. Carr held the position of Medical Director, Women's Pelvic Health Centre at Sunnybrook. She is actively involved in the training of medical students and surgical residents at the University of Toronto. In addition to maintaining a busy medical practice, her research interests include the study of bladder dysfunction and incontinence, interstitial cystitis and urinary tract infections.CLOSE
Nurse Continence Advisor, Sunnybrook Health Sciences Centre
Fran Stewart, Nurse Continence Advisor, is a committed educator in the field of pelvic floor disorders including incontinence. Her interest and involvement with incontinence…READ MORE
Fran Stewart, Nurse Continence Advisor, is a committed educator in the field of pelvic floor disorders including incontinence. Her interest and involvement with incontinence developed out of the realization that many people thought this condition was "normal". Fran and her health care team often see more than 30 new bladder patients per week to determine a correct diagnosis and help ensure patients receive the right treatment and care for incontinence problems. Vice President of the Urology Nurses of Canada for Central Canada, she joined this organization to help integrate the fields of urology and urogynecology and to actively promote incontinence awareness among patients and physicians. Highly regarded for her personal approach to addressing concerns on incontinence, Fran is often referred to as the "Bladder Queen", a term that accurately describes her dedication to this field.CLOSE
Dr. Marie-Paule Jammal
Urologist, Cité-de-la-Santé Hospital
Dr. Marie-Paule Jammal, trained in Montreal, is a urologist at the Cité-de-la-Santé Hospital in Laval, Québec. An active community urologist, she is also the President of the…READ MORE
Dr. Marie-Paule Jammal, trained in Montreal, is a urologist at the Cité-de-la-Santé Hospital in Laval, Québec. An active community urologist, she is also the President of the Québec Urological Association's (QUA) Continuing Medical Education Committee. A member of the QUA education committee since 2000, the QUA board since 2001, Dr. Jammal has also been a member of the examination committee for the Québec College of Physicians. Dr. Jammal participates in many clinical trials, and scientific programs. She is a member of the Surgical Acts Surveillance Committee at Cité-de-la-Santé hospital.CLOSE
Nurse Continence Advisor, Montreal General Hospital
Beverly Cleland is a nurse continence advisor at the Montreal General Hospital campus of the McGill University Medical Centre. Working primarily with incontinence…READ MORE
Beverly Cleland is a nurse continence advisor at the Montreal General Hospital campus of the McGill University Medical Centre. Working primarily with incontinence and cancer patients, she not only provides in-depth incontinence consultations but also biofeedback training. Educated and trained in Montreal, Cleland has worked in a number of patient care areas including general, plastic and vascular surgery, and as a liaison nurse for home care and for patients in Northern Québec. In addition to her busy practice, she performs urodynamic studies for the urology and gynecology departments at McGill University.CLOSE
Ask an Expert
A group of drugs that alter the normal signalling pathways in the body that regulate the urge to urinate. by urgency, this can be distressful and sometimes debilitating.
A technique used by patients with therapists or continence nurses, where available. Information is presented to the patient and/or therapist as visual, auditory or tactile signals.
The inability or difficulty in having bowel movements.
A watery stool that is passed several times in one day.
The smooth muscle in the bladder. Contraction of the detrusor bladder muscle causes urine to be expelled through the urethra.
The need to urinate up to eight or more times during the day and night.
A group of drugs that alter the normal signalling pathways in the body that regulate the urge to urinate. by urgency, this can be distressful and sometimes debilitating.
An imbalance of progesterone and/or estrogen levels in an individual's body.
Increased Daytime Frequency
Patient considers they need to urinate too often during the day.
Mixed Urinary Incontinence
Involuntary leakage associated with urgency and also exertion, effort, sneezing or coughing.
Waking at night to go to the bathroom one or more times.
Stress Urinary Incontinence
Leakage of urine caused by physical activity, laughing, sneezing or coughing, is often confused with overactive bladder
Pelvic Floor Muscles
Muscles that form a sling or hammock across the opening of the pelvis to keep all of the pelvic organs (bladder, uterus and rectum) in place and functioning correctly.
A V-shaped casing with a foam cushion that fits around the penis. When closed, this stops the flow of urine without causing discomfort.
Pelvic Floor Muscle Exercises (PFMEs)
Repetitive exercises involving contraction and relaxation of specific pelvic floor muscles. Performed to strengthen muscles that support the urethra, bladder, uterus and rectum.
Selective β3-adrenoceptor agonist
A class of drug that differs from antimuscarinics due to its distinct mechanism of action which helps to increase bladder capacity by relaxing the detrusor smooth muscle during the storage phase of the urinary bladder fill-void cycle.
The tube that carries urine from the bladder to outside the body.
Urge Urinary Incontinence
The involuntary leaking of urine.
The sudden and compelling need to urinate which is difficult to defer.
A physical and/or chemical examination of the urine, which consists of a number of chemical and microscopic tests to screen for urinary tract infections, renal (kidney) disease, and diseases of other organs that may result in the appearance of abnormal metabolites in the urine.
Any involuntary leakage of urine.
A ring-like band of muscle that closes the urethra.
Urinary Tract Infection
A bacterial infection of the urethra, bladder, ureters or kidneys (part of the urinary tract).
An infection that occurs in the vagina. This may be accompanied by vaginal discharge, itching and an unpleasant odour.
Small plastic devices inserted into the vagina to hold the bladder neck in place and prevent leakage of urine.
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Questions about overactive bladder (OAB)? The Quick Guide provides "the facts" on OAB and is a great brochure for individuals with OAB, family or friends of sufferers or healthcare professionals. Print off a copy for yourself or give it to a friend or family member.
One of the first steps toward determining whether you have OAB is to keep a bladder diary. Documenting symptoms (e.g. frequency of voiding, degree of urgency, wetting episodes) can help your healthcare professional make the proper diagnosis. Below is a sample that you can print and use.
In some cases, there is a test that a specialist may perform, called an
urodynamic test, to help evaluate the cause of your symptoms and guide your treatment. For this test, a catheter (a small plastic tube) may be passed into the bladder and rectum, and fluid is then used to fill the bladder. During the test, you will be asked how your bladder feels and when you feel the need to urinate. While emptying your bladder, the volume of water and the bladder pressure will be recorded. Test results can help to determine how your bladder
muscles are working.