Overactive bladder: Symptoms, myths, and misconceptions

Date: Apr-06-2017 Overactive bladder is a common condition marked by symptoms relating to the frequency and urgency of urination.

In the United States today, overactive bladder (OAB) may impact as many as 40 percent of women and 30 percent of men.

The chances of developing OAB increase with age but the condition is not a byproduct of aging. Most OAB cases begin with minor symptoms that progress over the long-term.

Contents of this article:

What is OAB?

Symptoms of OAB

OAB vs. stress urinary incontinence

Myths and misconceptions about OAB

What is OAB?

A sudden urge to urinate when the bladder isn't full may be sign of an overactive bladder.

OAB describes a group of urinary symptoms rather than a specific disease. It is a common condition worldwide.

It is also called unstable or irritable bladder, and those with OAB often have a sudden, uncontrollable urge to urinate even if the bladder is not full.

Typically, the bladder gets a signal from the brain to empty when half full, or holding around 2 cups of urine. The sphincter muscle then relaxes and the detrusor muscle contracts to push out urine.

When some sort of a disruption occurs anywhere in this process, OAB symptoms and incontinence can occur.

Based on the two largest OAB surveys conducted to date, the EPIC study and the National Overactive Bladder Evaluation study, the rate of OAB among those over 18 varies from 11 to 16 percent.

A cross-sectional study of American men and women found 8 percent of men reported experiencing OAB symptoms often and 17 percent sometimes. In the same study, 20 percent of women reported experiencing OAB symptoms often and 30 percent sometimes.

Different ethnic groups may experience differing prevalence rates for OAB. Some studies have shown an increased rate of OAB in African American men and women as well as Hispanic males.

Symptoms of OAB

The physical symptoms of OAB vary but typically involve a loss of urinary control and the feeling of needing to urinate more often.

Around half of those with OAB also experience urgency urinary incontinence (UUI), or urine leakage.

Men and women experience differences between symptoms based on anatomical differences.

The EPIC study found that women with OAB might experience symptoms related to the storage of urine more frequently than men. The study also found that men with OAB tend to experience more issues with the release of urine than women.

The most common symptoms of OAB include:

A symptom of OAB may be the urge to urinate when hearing running water.

urinary urgency, or being unable to control urination

urinating more than 8 times a day

uncontrollable urge to urinate spontaneously, especially when hearing running water

the need to wake during the night to urinate

leakage of urine due to a failure to make it to the washroom

bed-wetting

strain or discomfort during urination

An increase in urination frequency and loss of bladder control are only symptoms of aging to an extent. Anyone at any age can develop OAB. A doctor should also be seen if symptoms become worrisome, or a burden to everyday life.

The symptoms of OAB can be disabling. One study found that the rate at which work productivity was impaired in people with OAB compared to those without, was roughly four times higher for men and three times higher for women. These rates are comparable with the rates of other long-term conditions like asthma.

Many with OAB don't seek help from their doctor because they don't know how to talk about their symptoms, or aren't aware of treatment options.

Many people with OAB also avoid treatment out of embarrassment. The National Association for Continence estimate that only 45 percent of those with OAB seek treatment.

The American Urology Association offer a printable quiz that can make starting the conversation about OAB symptoms easier.

There are also tools available to track symptoms. There are free apps that can be used to monitor fluid intake, urination, and leakage. A bladder diary can also help track the movement of liquids through the body.

Many with OAB will also experience emotional and mental symptoms as the result of the condition's physical symptoms.

Further complications of OAB include:

social or workplace anxiety

loss of sleep or sleep quality due to needing to urinate at night

depression often related to lack of sleep

decreased sense of intimacy

strained relationships with partners

lower self-confidence

reduced physical activity

OAB vs. stress urinary incontinence

Stress urinary incontinence is not the same as OAB. Stress urinary incontinence (SUI) occurs when urine leakage accompanies activities like laughing, light coughing, or sneezing.

Lifting and straining can also trigger urine leakage in those with SUI. Even standing up, bending over, or walking can be enough to cause urine leakage with moderate to severe cases of SUI.

Unlike OAB, people with SUI typically do not experience problems with the urgency or frequency of urination. People also only pass a small amount of urine during incidents.

Roughly one in three women in the U.S. have SUI. White and Hispanic women are more likely to develop SUI than African American women. Several other factors can also contribute to the development of SUI, such as:

childbirth

nerve damage

smoking

obesity

chronic coughing

Most cases of SUI are linked to a weakening of the neck of the bladder. Vaginal childbirth, obesity, aging, and menopause are also major causes of SUI.

Performing pelvic floor muscle activities, losing weight, or stopping habits like smoking that lead to coughing, can often lessen or improve SUI symptoms. Minimally invasive surgery options exist to treat the condition as well.

As in OAB, people with SUI often experience emotional and mental symptoms alongside the physical symptoms of the condition. Depression, social anxiety, and decreased sense of intimacy are common.

The symptoms of OAB are also sometimes confused with those of benign prostatic hyperplasia (BPH), an enlargement of the prostate that is common among men over 50. Most people with BPH wake several times through the night to urinate and have a slower, weaker stream of urine.

If burning, intense pain, or blood accompanies urination, a person should see a doctor immediately. A doctor should also be consulted if urine flow stops completely. The American Urological Associated have a BPH symptom score index that can be filled out before a person visits their doctor.

Myths and misconceptions about OAB

There are a number of misconceptions about OAB. While some of these have a base in science, simplifying patterns, or placing too much importance on apparent links, can be more harmful than helpful.

Many people who do not seek treatment for OAB have been misinformed about the facts of the condition.

A common myth about OAB is that it's simply a part of aging or it can be controlled by limiting fluid intake.

Common myths include:

OAB is simply part of aging

OAB in men is usually caused by an enlarged prostate or prostate conditions

OAB is the result of a small bladder

OAB symptoms are caused by overexertion or activity

OAB can be controlled by limiting fluid intake

OAB is a woman's condition

OAB is simply something to live with

everyone gets OAB eventually

OAB has few or no treatment options

most people with OAB don't see reduced symptoms with treatment

surgery is the only treatment option for OAB

Written by Jennifer Huizen

Courtesy: Medical News Today Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.