Millions of people worldwide, both men and women suffer from overactive bladder and do not seek medical help because they are unaware that they have a treatable condition.
The most common symptom of overactive bladder is urinary frequency, which means urinating more often then every two hours. A second common symptom is urgency, which means that the desire to urinate becomes so strong that all other business must be put aside and urination permitted without delay. Despite the patient’s best effort to get to the toilet in time, the urgency may become so severe that urinary leakage or incontinence occurs.
The third most common symptom is nocturia, which means awakening from sleep in order to urinate. If the patient isn’t sufficiently roused from sleep by the urge to urinate, bedwetting may occur.
Whatever the cause of overactive bladder may be, the symptoms are related to unwanted contraction of the muscle fibers in the wall of the bladder due to inappropriate nerve impulses that control the contraction of the bladder muscle fibers.
The condition is generally thought of as being divided in two categories, overactive bladder dry and overactive bladder wet. If you experience urgency four or more times a month but remain dry, you’re likely in the first group. If, in addition, you wet yourself at least three times in the past month, without the wetness being the result of straining, coughing, sneezing or laughing, you are more likely to be in the overactive bladder wet group.
There are many possible causes underlying the development of this troublesome and embarrassing condition such as bladder outlet obstruction due to prostate enlargement, or underlying neurological causes such as multiple sclerosis, stroke and Parkinson’s disease. However, most commonly, no specific cause can be found.
The treatment of overactive bladder is first to try to establish and treat any underlying cause such as prostate enlargement or neurological problem. If no specific cause of overactive bladder can be found, behavioral and medication therapy can be used. Behavioral therapy includes education regarding the basic function of the bladder, dietary and fluid moderation, timed scheduling of urination, pelvic exercises and maintaining a time and amount urination diary.
There is a long list of medications, which have been used for the treatment of overactive bladder. They have been used in various dosages, combinations with each other and by different routes of administration.
Unfortunately, there are side effects associated with most of the drugs used. The most common side effect is dry mouth, followed by blurred vision, constipation, confusion, especially in the elderly, fast heart rate and a fall in blood pressure on standing up too quickly. Botox, used by dermatologists for the treatment of wrinkles, is being investigated for direct injection into the bladder muscle wall for the treatment of overactive bladder. This however, is still considered experimental.
Have a question? Call Dr. Okun at 718-241-6767
