The bladder collects urine from the kidneys and expels it when it is full. If a bladder is overactive, a person cannot control when they choose to urinate, and the number of times they urinate during the day.
The condition occurs when a person's bladder squeezes frequently or without warning. As a result, they may have to use the bathroom more frequently or urine may leak out.
The condition is usually the result of miscommunication between the brain and the bladder. The brain signals to the bladder that it is time to squeeze and empty, but the bladder isn't full. As a result, the bladder starts to contract. This causes a strong urge to urinate.
While the condition may be common, it doesn't have to mean a person has to live with the symptoms. Many treatments are available that can help people reduce their symptoms.
An overactive bladder will cause a group of symptoms, all of which can affect a person's quality of life.
Examples of these symptoms include:
- Frequency of urination: A person will urinate more than eight times a day.
- Nocturia: A person cannot sleep through the night without waking up to urinate, usually one to two times.
- Urinary urgency: A person will experience a sudden and uncontrollable urge to urinate.
- Urge incontinence: A person will leak urine when they experience the urge to urinate.
A person with an overactive bladder may often feel like they can't completely empty their bladder. They may use the restroom and then feel like they need to go again a very short time after.
Doctors divide overactive bladder into two types based on their symptoms. The first type is overactive bladder, dry. According to Cedars-Sinai Hospital, an estimated two-thirds of people with overactive bladder have the dry variety.
The second type is overactive bladder, wet. A person with this condition experiences a leaking bladder. Those with overactive bladder, dry, do not have the leaking symptoms.
Some patients may pass off their overactive bladder symptoms as a natural part of getting older. However, aging isn't the only risk factor that could increase a person's risk of experiencing an overactive bladder.
Additional risk factors include:
- nerve damage due to a history of surgery
- trauma to the upper body or pelvis that damages the bladder
- having a condition known as normal pressure hydrocephalus, a cause of dementia
- having a urinary tract infection
- history of bladder or prostate cancer
- history of bladder stones
- history of conditions that affect neurological function, such as multiple sclerosis, Parkinson's disease, or stroke
- having gone through menopause
- eating a diet high in foods that make the bladder more "irritable" or likely to be overactive
Examples of the types of foods that can make the bladder overactive include caffeine, alcohol, and spicy foods.
A doctor may not be able to say why a person is experiencing overactive bladder symptoms. The symptoms can seem to occur spontaneously.
Although overactive bladder isn't thought to be a life-threatening condition, the condition can greatly affect a person's quality of life. Many treatments are available to lessen symptoms, although doctors can't cure the condition.
Examples of signs that a person should seek treatment for an overactive bladder include when:
- a person cannot sleep throughout the night without waking up to go to the bathroom
- a person uses the restroom more than eight times per day
- a person frequently experiences sudden urges to urinate and rarely makes it to the bathroom
- a person experiences urine leakage regularly
A person may sometimes experience these symptoms and yet not realize the degree to which they have them. There are several tools that can help assess the likelihood that the symptoms may be related to overactive bladder.
Examples of these tools include:
- An online quiz regarding overactive bladder symptoms and severity, which is offered by the American Urological Association.
- A "bladder diary" that a person can keep of the foods and drinks they consume plus how often they go to the bathroom and have symptoms, such as urinary urgency and incontinence.
- Smartphone apps, which a person can download that help them keep a bladder diary by tracking how much they drink, number of trips to the restroom, and urinary leakages that occur.
Using these tools can help track the regularity of someone's symptoms and sometimes confirm that symptoms are cause for concern.
However, a person should always see their physician if they are having bladder symptoms they are worried about.
Some foods and drinks are known to contribute to bladder irritation. As a result, making lifestyle changes can help a person reduce the likelihood they will experience overactive bladder symptoms.
Examples of steps to take include:
- Limiting intake of caffeine and alcohol, which can stimulate the bladder.
- Maintaining a healthy weight. Excess weight can place too much pressure on a person's bladder.
- Increasing fiber intake, which can reduce the risk of constipation and the likelihood of an overactive bladder.
- Adjusting fluid intake so that a person doesn't drink as much fluid in the evening. This helps to decrease the likelihood of them waking up overnight with the need to urinate.
- Stopping smoking, as smoke can be irritating to the bladder.
A doctor can recommend many treatments for overactive bladder, including medications, dietary changes, and physical therapy. Rarely, a doctor may recommend more invasive measures to treat the condition.
Doctors can prescribe a number of medications to treat an overactive bladder. These medications are usually known as antispasmodics or anticholinergics. They reduce the incidence of muscle spasms, such as the spasms in the bladder.
Examples of these medications include:
- oxybutynin (Ditropan)
- solfienacin (Vesicare)
- tolterodine (Detrol)
- trospium (Sanctura)
These medications are not without their side effects, such as dry mouth and constipation. People should always talk to their doctor regarding potential side effects.
A number of therapy treatments exist for overactive bladder. One example is bladder training. This is a method used to strengthen the muscles of the bladder by delaying voiding. Bladder training should only be done with the advice and direction of a physician.
Pelvic floor exercises and vaginal weight training are also therapy methods used to strengthen the bladder muscles. Specialists, called pelvic floor therapists, can instruct a person through these exercises.
More invasive approaches
Doctors are using injections of botulinum toxin (such as BOTOX) to reduce muscle spasms to the bladder. However, this may require further injections after a few months as the toxin wears off.
If a person's overactive bladder does not respond to medications, therapy, or other non-invasive treatments, a doctor may recommend surgery.
One example is the implantation of a sacral nerve stimulator. This stimulator can help to control the nerve impulses to the bladder, making the muscles less overactive.
Another option is a procedure known as augmentation cytoplasty. This involves replacing portions of a person's bladder with bowel tissue. As a result, a person's bladder is better able to tolerate a larger volume of urine.