Overactive bladder, or urge incontinence, is a condition that occurs when bladder muscles contract involuntarily creating an unstoppable urge to urinate.Causes of Overactive Bladder
The condition is seen in women of all ages, but is more common in older women. It is caused by bladder spasms brought on by problems with the muscles and nerves that control the bladder. These spasms can cause an intense urge to empty the bladder even when the bladder contains only a small amount of urine.
Sometimes a cause for overactive bladder can’t be identified. Abnormalities of the nervous system or other factors that are linked to overactive bladder include:
- Neurological conditions, like Parkinson’s disease and multiple sclerosis
- Diabetes
- Side effects of certain medications, especially diuretics
- Bladder tumors, stones or cancers
- High intake of caffeine or alcohol
- Bladder flow obstruction caused by constipation or other conditions
- Conditions that cause incomplete emptying of the bladder
Urinary tract infections can also lead to urinary urgency and produce symptoms similar to those of overactive bladder.
Tests to determine the cause of overactive bladder and evaluate bladder function may be recommended by your gynecologist.
Treatment of Overactive Bladder
Many women with overactive bladder see improvement of symptoms with bladder training. Instead of responding immediately to the urge to urinate, a urination schedule is set-up. The goal of scheduled voiding is to empty the bladder at a scheduled time around the clock therefore avoiding urges and thus accidents. Once successful, the scheduled time intervals are gradually increased.
Pelvic floor exercises, or Kegels, can be done to strengthen the muscles that control urination.
Other non-medical steps that may be helpful include reducing alcohol and caffeine intake, losing weight and reducing excessive fluid intake.
Medical treatments to control overactive bladder include:
Medications:
- Darifenacin (Enablex)
- Fesoterodine (Toviaz)
- Oxybutynin (Oxytrol, Ditropan)
- Solifenacin (Vesicare)
- Tolterodine (Detrol)
- Trospium (Sanctura)
- Mirabegron (Mybetric)
- Imipramine hydrochloride (Tofranil)
Bladder Injections:
Onabotulinumtoxin A – (Botox) – Can be injected directly into the bladder to temporarily (6-9 months) partially paralyze bladder muscles.
Nerve Stimulation:
An implantable device that carries electrical impulses to the sacral nerves that control bladder.
Surgery:
Severe cases of overactive bladder may require bladder surgery when other treatment methods fail.