Overactive Bladder
What is overactive bladder (OAB)?
Overactive bladder (OAB) is a form of urinary incontinence involving a sudden, uncontrollable urge to urinate. Some experts
estimate that one in six adults over age 40 experience symptoms of OAB.
What causes OAB?
The root cause of OAB is unknown. However, the condition results when the detrusor muscle—the bladder muscle that controls
the expulsion of urine through the urethra—malfunctions. Underlying reasons for a malfunctioning detrusor muscle may include:
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Bladder stones
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Drug side effects
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Nerve damage, which can be caused by abdominal trauma, pelvic trauma or surgery
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Neurological disease, such as multiple sclerosis, Parkinson’s disease, stroke or spinal cord lesions
In addition, some experts believe that certain individuals – including those with depression, anxiety and/or attention deficit
disorder – may be predisposed to OAB.
What are the symptoms of OAB?
Physical symptoms of OAB include an urgent need to empty the bladder, more frequent urination during both day and night, as
well as incontinence.
OAB can affect daily living by interfering with work, everyday routines and even intimacy and sexual function. It can also
take a toll on emotional well being, causing embarrassment, stress and, in some cases, depression.
What are the treatments for OAB?
Although OAB is highly common, studies suggest that many sufferers do not seek medical treatment. However, there are several
treatment options that can help to alleviate the physical symptoms and, ultimately, the emotional “side effects,” as well.
Those treatment options include:
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Bladder training, for which the patient urinates at designated times and uses relaxation techniques and distractions to help keep to the schedule.
Gradually, the patient tries to lengthen the time between scheduled urination.
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Medication, which may include oxybutynin chloride (Ditropan XL®) or tolterodine (Detrusitol®, Detrol LA®). These prescriptions are taken
orally, once a day, for OAB. As antimuscarinics, these drugs affect the central nervous system and the muscarinic receptors
in smooth muscle. These drugs typically show results within about two weeks. Newer medications indicated for OAB include trospium
chloride (Sanctura®), derifenacin (Enablex®) and solifenacin (Vesicare®).
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Oxybutynin transdermal system (Oxytrol®) is a clear patch that’s thin and flexible. Twice a week, it’s applied to the skin of the abdomen or hip. The
patch delivers oxybutynin continuously through the skin into the bloodstream, thereby relieving symptoms for up to four days
at a time.
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Sacral nerve stimulation (InterStim®) therapy is an implanted neurostimulation system. It sends mild electrical pulses to the sacral nerve, which
the nerve near the tailbone that influences bladder control muscles. Stimulation of this nerve may relieve the symptoms related
to urge incontinence. This reversible treatment is best suited for patients who do not respond to behavioral therapies.
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Surgical augmentation of the bladder is a last resort for those who do not respond to bladder retraining or to medication.
