Overactive bladder (OAB) refers to a syndrome of urinary symptoms associated with difficulty in storing urine in the bladder. OAB affects up to 10 to 12% of adults.
The four main symptoms of OAB are:
- urgency – a strong desire to pass urine
- frequency – where patients complain they need to pass urine too often during the day time
- nocturia – needing to wake up two or more times at night to pass urine
- urge urinary incontinence (UUI) – involuntary leakage of urine, preceded by a urinary urgency
Not all patients with OAB experience all of these symptoms, and the severity of symptoms varies significantly from person to person. For example, some individuals may have urgency and frequency during the daytime, but may not have to wake up at night to pass urine. And only about a quarter of people with OAB tend to experience UUI.
While OAB is not considered a dangerous condition, the symptoms can have a very negative impact on quality of life, preventing people from undertaking their normal work or activities, and also causing significant psychological stress and embarrassment.
OAB occurs in people of all ages, and is about four times more common in women than men. In many cases of OAB, there may not be any obvious cause, it can be secondary to a number of conditons:
- blockage from prostate enlargement
- diabetes
- drinking excessive amounts of water, or caffeine containing drinks (coffee, tea, cola, energy drinks)
- medications, such as diuretics or blood pressure tablets, that cause sudden filling of the bladder
- weak bladder outlet , or previous incontinence surgery, in women
- neurological conditions, such as Parkinson’s disease, stroke or multiple sclerosis
- constipation
- dementia
There are a number of treatment options for OAB, but the first thing to consider is whether you need to modify any lifestyle factors, such as decreasing the amount of fluids you drink, particularly caffeine containing drinks or excessive alcohol consumption. There is no scientific evidence to suggest that drinking large amounts of water (more than 1.5-2 litres a day) is beneficial for your health, but it will cause you do pass urine more frequently and urgently.
In most cases, OAB can be treated with a combination of bladder training, and medications that relax the bladder and make it easier to hold a larger amount of urine.