DR YPS Rana is Senior Consultant (Urology, Andrology & Renal Transplantation) at BLK- MAX Super Specialty Hospital
Overactive Bladder (OAB) is a condition that's inconvenient, embarrassing and is potentially debilitating but could be managed now. Although this condition can be treated, most patients do not seek treatment or consult doctors. OAB is characterized as a syndrome that causes an abrupt and unstoppable need to urinate.
If left untreated, OAB can negatively impact life by interfering in daily activities such as work, social activities, exercise, and sleep. The incidence of OAB symptoms increases with age. Older patients are less likely to discuss their OAB symptoms with their physician and are more likely to be untreated or under-treated.
To manage OAB, the first step is to make lifestyle changes. Sometimes these changes are called behavioural therapy. People can see big improvements by changing their lifestyle and daily routine. Avoiding bladder irritants such as coffee, tea, carbonated beverages and spicy food will also yield a significant symptom control.
Weak pelvic floor muscles may contribute to overactive bladder. Pelvic floor muscle exercise or Kegel exercise help reduce OAB symptoms by improving this muscular control on being able to hold back urine but can take a few weeks to show results. However, this needs consistency.
Both men and women can get OAB. It is an under-reported problem in our country. Therefore, the exact number of cases is not known. However, some studies mention that around 14 per cent men suffer from OAB whereas around 12 per cent women have some type of urinary incontinence issue.
Older women who have gone through menopause and men who have had prostate problems are more likely to get OAB. People with diseases that affect the brain or spinal cord (nervous system), such as stroke and multiple sclerosis also get OAB. Growing older is a factor, but not all people get OAB as they age. Therefore, it shouldn't be considered as a normal part of aging.
Management of OAB involves an escalatory or stepping up the ladder approach. The basic and vital step revolves around self-management by behavioural and lifestyle changes. The next levels are: pills or oral medicines, progressing further to injections into the bladder wall, electrical stimulation of bladder-related nerves and finally, but very rarely, surgery.
As a further step, doctors might decide that oral medications are necessary to help manage the symptoms. Typically, these medications work by calming the overactivity of the muscle in the bladder wall, thereby reducing both frequency of and unwanted urges to urination. Often oral medications work better when combined with behavioural therapy.
If lifestyle changes and medicine aren't working, there are other treatment options like injections in the bladder or nerve stimulation techniques. In OAB, the nerve signals between bladder and brain, through the spinal cord, do not communicate correctly. Electrical pulses via nerve stimulation help set right these nerve signals to the bladder, so that it can function optimally and improve OAB symptoms. Only in very rare and serious cases is surgery to be used.
Early diagnosis and prompt treatment are proven means of reducing severity of both symptoms and complications of OAB. So, don't delay getting help for your condition or discussing your concern with a family member if you suspect he or she may be struggling with OAB symptoms.
