Overactive Bladder Symptoms
When we think about people with overactive bladder (OAB), our first thought usually tends to be pregnant women or elderly people. While they may be susceptible to bladder problems, they’re just a small part of the population of OAB sufferers.
OAB does not occur with every pregnancy, as well as OAB is not a normal part of the aging process, although common. We need to broaden our scope of who suffers from OAB, what OAB is, and how we can find solutions to the difficult overactive bladder symptoms.
The more we discuss what OAB is to us, the more we spread awareness and destigmatize it.
What Is Overactive Bladder?
What exactly is OAB? OAB is not a disease, but a chronic condition that is a combination of four major symptoms: frequency, urgency, urge incontinence, and nocturia.
Someone with OAB may suffer from any or all four of these symptoms every day. OAB does not discriminate. It can affect anyone at any time in their life, as well as it can be a recurring issue.
The most commonly reported symptom of OAB is urgency. OAB can be mistaken as being only a condition for women as well. There’s more attention in the media to protection made for women, then there are men, if at all.
OAB also can be mistaken as something you cannot fix as its attributed to a “small" or “tiny" bladder. These are misconceptions as it’s very unlikely that you have an abnormally small bladder, rather than your bladder is overactive for certain reasons.
What Causes Overactive Bladder?
There is no clear explanation as to what causes OAB, however, OAB can be caused by neurological damage that happens in conditions like Parkinson’s disease and diabetes.
It can be a result of a UTI, an illness, damage to the nerves in your spine or sacral region, or a side effect of medication.
Regardless of what causes OAB, there are many ways to treat OAB ranging in levels of severity. We can also live with OAB without treating it; rather by adjusting your lifestyle to control it, instead of letting it control us.
The Symptoms of Overactive Bladder
In terms of symptoms, OAB is a targeted condition, not a systemic one. This means OAB discomforts are all focused on and around the bladder.
Frequency
Frequency is when your bladder is telling your brain it needs to urinate more often than what makes sense for what you’re intaking. However, your frequent washroom visits might be coupled with smaller amounts of urine being expelled.
While you may think that your washroom habits are normal, it could be far from the truth. Some doctors will say urinating 8 or more times during waking hours is overactive, especially if you haven’t been drinking a lot of fluids.
One thing to note is that everyone has their normal, and sometimes normal is urinating 8 times a day, but you also might be intaking 2 or 3 times the amount of fluid most people drink to keep your body going.
Frequency may not sound like such a big deal, however, it’s a much bigger deal when you dissect it. At the very least, having to visit the washroom more often is inconvenient and annoying. It can disrupt important events, meetings, and work.
It can be the cause of humiliation as some people will comment on your “small bladder," and make you self-conscious of each visit, which in turn can make you want to hold onto your urine longer just to make a point to yourself that it’s not urgent. But frequency can be a symptom of other larger health risks.
Often people who don’t suffer from OAB can experience frequency when they drink coffee and alcohol, as it’s a diuretic and will increase urine production. However, when you do suffer from OAB, drinking things like coffee and alcohol can worsen your overactive bladder symptoms, and your frequency will go up.
Coping With OAB Frequency
With OAB, we need to find ways to take back our lives. Frequency is just one of the many challenges we face every day with OAB, but it isn’t impossible to get under control. Even though this may sound counterproductive, water is always going to be your best friend in cases like these. You will never want to deprive your body of water.
What happens if you do? Unfortunately, your urine becomes very concentrated and dense which is very irritating to the bladder walls. This means that because your OAB is more highly sensitive to changes like these, it will be affected more than the average person.
So depriving yourself of water, or not drinking enough is only going to make your urine more concentrated and irritating to the bladder, making you need to go much more frequently and with a lot more urgency as well.
Urgency
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.
Urge Incontinence
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.
What Can Help Urge Incontinence?
Urge incontinence is difficult to prevent, although there are ways to help.
Using Physical Therapy, Pelvic Floor/Kegels for Urge Incontinence
One major help with urge incontinence is pelvic floor physiotherapy or pelvic floor exercises. Otherwise referred to as Kegels, these exercises will help you gain better control over your pelvic floor which contracts and relaxes depending on whether you need to urinate or not.
When you relax your pelvic floor, you are able to pass urine out through your urethra. When you contract your pelvic floor, it stops the flow of urine. However, when your pelvic floor muscles are weaker they won’t be able to stop the flow of urine when you want them to.
Practicing pelvic floor exercises will help you find your muscles and know when they are contracted or relaxed. There are many benefits to pelvic floor exercises, as well as seeing a physiotherapist to help keep you on track with your progress.
Deep Breathing, and Anxiety and Stress Reducing Exercises
Another way to help with urge incontinence is with slow breathing exercises. Research shows that OAB is associated with self-reported increased anxiety and stress as well as abnormal autonomic nervous system behaviors (the part of the nervous system that controls bodily functions that are not consciously controlled).
Methods of reducing anxiety and stress, such as slow breathing techniques, may be able to help reduce OAB. Being able to slow down your breathing to 5-10 times per minute for about 10 minutes a day reported being may decrease your anxiety and stress, but also may decrease your overactive bladder symptoms, specifically urge incontinence, as it is related to autonomic control.
Breathing from your stomach as opposed to your chest is also beneficial in that you’re not holding down your stomach muscles while your lungs expand. This can cause unwanted stress in the abdominal region that is attributed to an overactive bladder, as the whole abdomen sits on the pelvic floor muscles.
Nocturia
Last but not least is nocturia. Nocturia is waking up more than one time throughout the night, disturbing your sleep cycle, to go use the washroom. This ties all the symptoms together as nocturia is related to frequency in that the frequent urination doesn’t stop after waking hours are over.
Frequent urination can follow us into the night. However, nocturia occurs when we wake up to experience the frequent urination. It stops being nocturia and starts being nocturnal enuresis when we don’t wake up to use the washroom, otherwise known as adult bedwetting.
Both nocturia and nocturnal enuresis can happen together, but one does not cause the other. Nocturia is also very common the older you get, and may not include all the other symptoms of OAB.
Having nocturia can cause you to have a disrupted sleep which ends up making you tired in the morning.
Avoid Coffee, Instead Drink Water
Those who are tired usually reach for something to perk them up, such as coffee. Coffee is a diuretic, as mentioned before, and will dehydrate you and you will expel the water that you need in your body.
Drinking more water to outweigh the coffee that was just ingested will help keep you hydrated, but you will have to urinate more. OAB is known for being a vicious circle of symptoms that just feed into each other.
Nocturia may be the last symptom, but it also may be the first. It depends on how you look at it. Keeping all the other symptoms in check will help with those overactive bladder symptoms, but probably not with nocturia, as you cannot be awake to control those functions.
Can Nocturia be Prevented?
To help prevent nocturia, it is recommended that you keep drinking fluids like water all throughout the day but stop a few hours before bedtime. As well as avoiding beverages like coffee or alcohol, especially before bedtime.
Another thing to aid in lessening nocturia is losing weight surrounding your abdomen as excess weight puts pressure on your bladder.
The Takeaway
Overall, it is your life you are living, and gaining some control over your bladder again is a good thing. Whatever makes you the most confident is something that you should invest your time in, whether its new medication, a procedure, or surgery, or nothing at all, be happy in what you decide to do for your health.
What we know about OAB is that it is a chronic condition that has no apparent cause and has no apparent cure. There are things that help some people, and other people need to go to the extreme to find relief from their symptoms. Small lifestyle changes can have a big impact on your OAB, but it is also recommended to see your doctor for it, in the event of other health concerns.
In a perfect world, everyone would be able to follow these tips and tricks and have a better grip on their OAB. Unfortunately, OAB is not a condition that is fair to your world, you, or your social life. Some sacrifices may need to be made if we are looking for a mild to medium relief in OAB symptoms.
There is no guarantee that OAB will go away with help, or with time. It might be recurrent, and it might come to us later in life. Some of us are born with OAB and bladder related issues.
OAB is a tricky, very common, but not well-known beast that simply will not go away. It is awkward to talk about, and it is awkward to have. However, if you have OAB, it is something you may live with for a very long time, so it is a good idea to become familiar with your symptoms to notice if anything changes, and how certain lifestyle changes can help.
OAB is almost never discussed in social circles, and it is something that should be. Bringing more attention to the problem could help others realize they are not struggling alone. If OAB brings people together to commiserate and share experiences and ways of handling it, then there is some good in this bad situation.
Remember not everyone experiences OAB in the same way. Some people have only one or two overactive bladder symptoms that control them, while others have all and then some. But no matter what, OAB is a chronic condition that affects your bladder and there is help out there to find relief of your symptoms. Don’t be afraid to ask for help.