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Prescription for Health

How to deal with an overactive bladder

Overactive bladder is a fairly common condition, which affects about 33 million Americans.  This equates to about 30 percent of all men and 40 percent of all women in the United States living with symptoms of an overactive bladder. An overactive bladder is not an illness per say, but rather a term used to describe a set of particular urinary symptoms such as incontinence, frequent urination, and waking up at night to urinate.

An overactive bladder can occur when there is an error in the nerve signals between your bladder and your brain.  Your brain signals your bladder to empty even if it is not full.  For this reason, those suffering from neurological diseases, such as multiple sclerosis or stroke, are at a higher risk of having an overactive bladder.  Additionally, when bladder muscles are too active, you can experience these same symptoms of overactive bladder. Your bladder muscles will contract before your bladder is full, and this will cause the urgency many experience to urinate.

Although men and women both suffer from this condition, the reasons can be quite different.  Below are some common causes of overactive bladder:

For Women:

• UTI – urinary tract infection

• Fibroids (Myomas) – non-cancerous growths of the uterus

• Cystitis – inflammation of the bladder

• Childbirth – pelvic muscles can become out of sync after childbirth and contract when they shouldn’t

• Idiopathic – cause is unknown

For Men:

• UTI

• Enlarged prostate

• Bladder Stones

• Bladder Cancer

So what is there to do?

If you are experiencing symptoms of an overactive bladder, you should talk to your internist and/or your urologist.  From an internist’s point of view, it may be smart to first rule out a medical issue that can cause frequent urination, like diabetes. An internist will also evaluate the changes in trends, if any, from year to year: How often are you going compared to last year?  Could this be stemming from a change in general health rather than be a strictly urological issue?

The first order of business for a urologist is to check the urine.  A urinalysis and urine culture can give a lot of clues as to what might be going on, especially in the event that there is an infection.  Urine can also be sent out for a cytology, which will look for abnormal cells in urine to rule out cancer.

Second, a minor office procedure called a cystoscopy can be done. This “scoping” involves inserting a small, lighted telescope into the bladder through the urethra.  This procedures enables the doctor to view the lining of the bladder for any abnormalities, as well as evaluate the prostate.  This visualization of the interior of the bladder can aid greatly in determining a diagnosis.

If this doesn’t work, another option is a urodynamic test, which is a computerized diagnostic tool to determine the cause of the overactive bladder.  The culprit could stem from a bladder or prostate  issue, as well as a myoma – a benign growth in the wall of the uterus.

Sometimes overactive bladder is age related. This is especially true for men, who naturally experience an increase in prostate size as they age.  As mentioned, enlarged prostate is a common cause of urinary frequency and incontinence.

Here are some tips if you are experiencing symptoms of an overactive bladder:

1. Cut down on caffeine and alcohol

2. Increase exercise and lose weight.  Regardless of the cause of overactive bladder, this will help mitigate the symptoms.

3. Medications, known as anticholinergics, can be taken in order to relax the bladder.  Some examples are Detrol, Ditropan, Enablex and Vesicare.  

4. Biofeedback physical therapy can help both men and women.  Physical therapy focused on strengthening the pelvic muscles can greatly reduce the symptoms of overactive bladder.  A well-known exercise which is incorporated in this therapy is the Kegel exercise.  

Dr. David B. Samadi is the Chairman of the Department of Urology and Chief of Robotic Surgery at Lenox Hill Hospital in New York City. He is a board-certified urologist, specializing in the diagnosis and treatment of urological disease, with a focus on robotic prostate cancer treatments. Dr. Samadi joined Fox News Channel in 2009 as a medical contributor. To learn more please visit his websites RoboticOncology.com and SMART-surgery.com. Find Dr. Samadi on Facebook.