The next symptom with OAB is urgency. Urgency can be one of the most difficult symptoms of OAB because of the little to no warning of such a strong need to urinate.
Usually, the feeling of urgency comes on very quickly, within seconds, and then continues to grow in level of intensity until relieved. This is a very uncomfortable symptom of OAB as it can almost be described as a few moments of a sharp sort of pain in your bladder.
There is no such thing as a gradual sense of needing to pee. Every notice of needing to urinate is immediate, its abrupt, and it's stressful: its time to find a washroom now!
Urgency makes your work and social life challenging. You could have recently visited the washroom when suddenly you have to go again. That can be particularly devastating as it doesn’t feel fair.
What Is OAB Urgency Like?
Most people who don’t have OAB don’t understand what its like to have a sudden urge to pee. When you have frequency and urgency together, it’s not a choice you make, rather it’s a race against time when you have an urge to pee.
What urgency in OAB looks like is that the bladder is particularly sensitive and tense and will start to contract when it senses fullness. Fullness, however, does not always mean the bladder is completely full. It means that when the bladder starts to feel full, it sends signals to the brain telling itself that it urgently needs to empty soon. There are no known reasons for why this happens.
What Can Help OAB Urgency?
Although urgency is an annoying and uncomfortable symptom of OAB, it is manageable.
Something you can do to help prevent bladder fullness and urgency is make a point to visit more restrooms when you’re indoors. Using the restrooms before leaving an establishment is a good method to avoid urgency and frequency at the same time.
Again, cutting back on caffeine and alcohol consumption will help with urgency and frequency as well.
However, when lifestyle changes aren’t always helping, there are other ways to help alleviate overactive bladder symptoms like urgency.
Treatment for OAB Urgency
There are medications, procedures, and surgeries available. Your doctor will have to exhaust one option before jumping down the line to the others, however, there are two popular procedures that stand out.
Botox Injections for OAB
With Botox being less invasive, Botox injections in the bladder wall has grown in popularity in helping patients, and its proven to show OAB symptoms significantly decrease. When you have a nervous and tense bladder, it needs some time to calm it down.
Botox works by calming down your nerves that overstimulate your bladder. It is injected all over the bladder muscle wall with certain placement. Its results can usually be felt within a day as your bladder becomes calm and relaxed and doesn’t overreact to the sensation of filling.
Neuromodulation for Urgency
The other more invasive solution is neuromodulation. This is a surgical procedure where a battery implant is placed in your buttock with a small lead that is placed on your sacral nerves in your tailbone. However, patients have to be approved for this surgery.
They have to go through a trial procedure with an external battery with an internal lead in the tailbone. If the trial period is successful, then the patient may be approved for the permanent implant. The success rate of the trial period must show at least 50 percent of improved overactive bladder symptoms to be approved.
With the trial period or the implant, the small lead from the battery provides a low constant stimulation to the sacral nerves that control bladder and bowel nerves.
This is one option for someone with high urgency with OAB because it has been proven to work with calming down the nerves that tell the bladder that it is sensing fullness and therefore must urinate. However, it is not for every patient, and sometimes does not prove successful, which is why the trial period plays a very important determining role for you and your doctor.
With urgency, there is also urge incontinence, which is the third symptom of OAB. Urgency is not always followed by urge incontinence, but urge incontinence is always followed by urgency. It is when you lose some urine following a feeling of urgency.
It can be one of the most embarrassing symptoms of OAB. When you have urge incontinence, it can be as small as a drop of urine, or as much as a gush of urine, but it is not a complete loss of urine as that would be classified as standard urinary incontinence.
Most people who suffer from urge incontinence typically wear a thin liner or an incontinence pad during the day to catch any urine they lose. However, those who don’t might experience embarrassment when out in public as it can stain clothing, be unsightly, and leave a smell.
Urge incontinence, as with the rest of OAB, is not specific to certain types of people. It does not discriminate, and it affects men and women alike, young and old.