Treatment And Medication Options For Overactive Bladder
Overactive bladder may be treated with lifestyle changes, drugs, office procedures, implantable devices, or surgery.
Guidelines from the American Urologic Association to treat non-neurogenic OAB, updated in 2019, recommend asfirst line treatment behavioral therapies such as
- bladder training
- fluid management -guideline” rel=”nofollow”> 4)
If lifestyle measures arent enough, youll most likely be prescribed a small dose of a drug, which can be increased as needed to control symptoms.
If drugs dont deliver the relief you need, your doctor may give you Botox injections to help relax your bladder muscle.
Both office-based procedures and implantable devices can deliver electrical impulses to the nerves that communicate with your bladder, helping it relax.
In rare cases, your doctor may recommend surgery to increase your bladders capacity or to remove it completely.
What Tests Should Be Ordered For This Patient
When overactive bladder is suspected, guidelines recommend limited investigations to rule out other causes of symptoms. These include urinalysis for urinary tract infection and hematuria. Urinalysis should be done to rule out urinary tract infection and hematuria. Urine culture may be considered if the urinalysis result is positive for one of the following: leukocytes, erythrocytes and nitrites.
Guidelines recommend a postvoid residual urine test if the history indicates incomplete emptying. The test can be done in the office by means of an ultrasound or bladder scanner, or by catheterization to measure residual volume if noninvasive means are unavailable.
What Causes Frequent Urination Pressure And Fullness
Frequent urge to urinate, Frequent urination and Pressure or fullness. WebMD Symptom Checker helps you find the most common medical conditions indicated by the symptoms frequent urge to urinate, frequent urination and pressure or fullness including Urinary tract infection , Diabetes, type 2, and Vesicoureteral reflux.
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Complications Of Overactive Bladder
Overactive bladder can have a significant negative impact on your quality of life. It can interfere with work, sleep, exercise, your social life, and your sex life.
Many people with OAB are nervous about having access to a restroom outside their home and may shy away from certain social activities or even everyday errands. This, in turn, may result in feeling isolated and lonely.
If you need to get up several times during the night to urinate, it may be difficult to get restful sleep. This can leave you tired during the day and contribute to mood disorders, like depression and anxiety.
And if youre worried that sexual activity will cause discomfort, that youll be interrupted by the need to urinate, or that youll leak urine, you may be reluctant to engage in sex. This can take a toll on relationships, causing further emotional difficulty.
In addition, urine leakage can lead to skin problems or infections.
What Is Frequent Urination
Frequent urination is the need to urinate more often than usual. There are two terms that are used to describe frequent urination: polyuria refers to an increased volume of urine and urinary frequency refers to the passing of a normal amount of urine, but the need to go more often.
Frequent urination is usually accompanied by a sensation of whats called urinary urgency, which is caused by involuntary contractions of the bladder muscle. Some people experience this feeling overnight, which is called nocturia.
Urine is composed of wastes and extra fluid, and its removed from the body through the urinary tract. You may not think about all of the body parts that allow you to urinate several times a day, but it actually requires all parts of the urinary tract to work together and function properly.
The kidneys work around the clock to filter your blood and produce urine. Then the ureters carry urine from the kidneys to the bladder, and the bladder stores urine until it becomes full and you feel the urge to urinate. At the bottom of the bladder is the urethra, which is made up of muscles that keep urine in the bladder and then allow it to exit it the body. But before you can urine, the brain has to send signals to the muscular bladder wall so that it will tighten and the sphincters that surround the urethra so that urine can exit the body.
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Natural Treatments For Frequent Urination
1. Pelvic Floor Training
Pelvic floor muscle exercises are usually one of the first lines of treatment for urinary issues like incontinence, overactive bladder and frequent urination. These exercises help to improve the strength, coordination and endurance of the pelvic floor muscles. Pelvic floor training is a type of exercise that involves muscle clenching.
One type of pelvic floor training is kegel exercises, which help to strengthen the muscles that wrap around your urethra. When you clench these muscles by contracting them and then relaxing them, they are becoming stronger and you can better control the act of urinating. For people dealing with frequent urination, kegels can help to support your bladder.
2. Bladder Training
Did you know that you can train your bladder? Some people are teaching their bladders some pretty bad habits and they dont even know it. For instance, some people dealing with frequent urination may be training their bladder to empty more often, before it is actually full. So you are getting the urge to urinate, even though you dont really have to just yet.
Do your best to wait the set amount of time before you urinate again, and if you find that you dont have to urinate when youve hit your interval, do it anyway. If you get the urge to urinate before its time, try some distraction techniques like taking deep breaths, relaxing your body and sitting in a chair and leaning down, which should relieve some pressure.
3. Watch Your Fluid Intake
Should I Be Worried If I Have These Conditions And Frequent Urination
If you ever have a symptom that is outside of whats normal for your body, reach out to your healthcare provider. In some cases, pregnancy, for example, frequent urination is completely normal and nothing to worry about. However, in some conditions, your caregiver may want to know if you are urinating much more than you typically do. Theres a very wide range of conditionswith varying levels of seriousnessthat could cause frequent urination. It is always safe to discuss your symptoms with your healthcare provider.
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When Should I Reach Out To My Doctor About Frequent Urination
Because the conditions behind frequent urination can range wildly from casual to severe, you should speak to your doctor about anything outside of your typical urination patterns. In some cases, frequent urination may be just an annoying symptom that will end when you cut back on the caffeineor have the baby. However, if you are unsure why youre urinating so frequently, it is best to set up an appointment and talk about it. This is a symptom that can often be treated and isnt something that you need to just deal with.
There are a few signs to keep an eye out for and call your doctor immediately if you have them with frequent urination. These include:
- If you have a fever.
- If you are vomiting.
- If you have back pain .
- If you see blood in your urine.
- If you have a discharge coming out of your vagina or penis.
Menopause And Frequent Urination: An Overview
As women go through menopause, they often experience changes in their urinary function and may find that they need to use the bathroom more often, and more urgently, than before. These changes are due to thinning of the tissues surrounding the vagina and urethra , which are a result of reduced estrogen levels.
In addition to this, the muscles in the pelvic area become naturally weaker with age. This can lead to urinary incontinence and other problems such as prolapses of the bladder or uterus.
Other related symptoms include vaginal dryness or itching, and a higher risk of developing urinary tract infections. Luckily, there are several treatment options available for frequent urination which include medication, exercise, dietary changes, and surgery.
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Urinary Urgency In Men
The condition of urinary urgency in men could be caused due to a wide range of reasons. The following article provides information on the causes, associated symptoms, and treatment of this condition.
The condition of urinary urgency in men could be caused due to a wide range of reasons. The following article provides information on the causes, associated symptoms, and treatment of this condition.
Urinary urgency, as the name suggests, is the sudden or compelling need to pass urine. In severe cases, it might be accompanied by urinary incontinence. It is more likely to affect the elderly. Frequent urination is an associated problem, which is characterized by the need to pass urine more than usual.
Bladder Has Two Distinct Roles
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What Causes Urgency & Frequency
Much urgency and frequency occurs because the bladder, muscles or nerve messages are not working normally, although urge and frequency is not yet fully understood. Common causes include:
- Overactive Bladder: This occurs when the bladder has problems storing urine. Symptoms include: wetting, urgency and frequent toileting .
- Dysfunctional Voiding: This occurs when your bladder and pelvic floor muscles are not co-ordinating well together and you develop habits such as not emptying your bladder completely. This can led to frequent toileting, wetting and urinary tract infections.
- Voiding Postponement: This occurs if you are in the habit of putting off going to the toilet and the urge becomes very strong, possible also resulting in wetting.
- Constipation: This occurs when you are not able to empty your bowel, or are having difficulty doing so. Bowel habits can have a significant impact on bladder function.
- Structural Problems: These issues related to your bladder, kidneys, muscles, nerves and urethra are rare. A medical specialist should be consulted if your child is identified as having an anatomical or neurological cause for wetting.
Assessments and treatments at the Mars Clinic are provided by advanced-trained Physiotherapists. The type and duration of treatment for urgency and frequency will vary depending on the cause of the problem and the needs of the individual. Treatment may include:
How Is Overactive Bladder Diagnosed
Your doctor will base a diagnosis of overactive bladder on your history of symptoms and other health conditions, a physical exam, and possibly certain screening tests.
To help diagnose OAB, your doctor may ask you about the following:
- Your specific symptoms
- How long youve had your symptoms
- Your history of other health problems
- Prescription and over-the-counter drugs you take
- Your diet and fluid intake
You may be asked to keep a bladder diary for a few days, which tracks your urination habits as well as your beverage intake and activities throughout the day.
Your doctor will examine you to see if any physical problems in your pelvic region are putting extra pressure on your bladder.
Tests can also help reveal whether you have an infection or a structural problem with your bladder, as well as show how your bladder responds to pressure and whether it fails to empty completely.
Bladder function tests may measure the following:
- How much urine is left in your bladder after urination
- Volume and speed of your urination
- Your bladder pressure
Taking these measurements may involve a variety of equipment and techniques, including an ultrasound scan of your bladder, inserting a thin tube into your bladder, urinating into a measurement device , or inserting a pressure sensor into your vagina or rectum.
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Symptoms Of Frequent Urination
A person is said to be facing frequent urination if they are having to urinate more often, with shorter and shorter durations between trips to the toilet and if the urgency to pass urine appears to be escalating.
A person with a normal urine cycle will have ample warning before the moment of urination and will not find it difficult to wait a few minutes at least before using the toilet. Further, if the person consumes 2-4 litres of water a day they should have at least 2 hours between every trip to the toilet.
The most tell-tale signs of frequent urination are as follows:
-
A strong urge to urinate every 30 minutes or so
-
A strong urge to urinate followed by a very small/negligible amount of urine
-
Loss of bladder control leads to bed-wetting especially at night
-
Pain or burning sensation while urinating
-
An unusual colour of urine
-
Difficulty in passing urine
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A constant trickle of urine through the day
What Should Be Included In The Physical Examination Of This Patient
According to the Canadian Urological Association, focused physical examination for overactive bladder includes abdominal and pelvic examination in women, as well as a basic neurologic examination. The pelvic exam includes assessment for vaginal prolapse and vaginal estrogen status, and a cough stress test for stress urinary incontinence . .
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What Treatments Should This Patient Be Offered
If investigations do not indicate another cause for the patients symptoms, guidelines recommend lifestyle modifications as first-line treatment of overactive bladder: total daily fluid intake of about 2 L/d, and reduced intake of caffeinated drinks because they can promote urinary urgency. Pelvic floor muscle training by an expert physiotherapist is also recommended by guidelines, especially if the patient is interested in nonpharmacologic therapy. Lifestyle modifications can be combined with second-line pharmacologic treatment, depending on symptom severity and patient preference. Guidelines recommend that pharmacologic treatment be prescribed if optimal improvement with conservative management has not been reached within 812 weeks after the start of treatment.
Non-antimuscarinic medications include mirabegron, tricyclic antidepressants and desmopressin. A systematic review supports the use of mirabegron, a novel 3 agonist specifically indicated for overactive bladder, because it causes relaxation of the detrusor muscle during bladder filling. The starting dose is 25 mg once daily, and the dose can be increased to 50 mg/d depending on effectiveness. Common adverse effects include headache and mild hypertension. These effects are no more likely than with antimuscarinic drugs however, mirabegron should not be prescribed to patients with severe uncontrolled hypertension.
When To Contact A Medical Professional
- You have fever, back or side pain, vomiting, or shaking chills
- You have increased thirst or appetite, fatigue, or sudden weight loss
Also call your provider if:
- You have urinary frequency or urgency, but you are not pregnant and you are not drinking large amounts of fluid.
- You have incontinence or you have changed your lifestyle because of your symptoms.
- You have bloody or cloudy urine.
- There is a discharge from the penis or vagina.
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What Causes Frequent Urination In Females
There are many different causes of frequent urination in females, but here we will highlight and describe some of the most common causes. We’ll start with some low-risk causes that are very treatable and work up to more high-risk causes for which frequent urination is a symptom of a serious disease.
Frequent Or Painful Urination At A Glance
- Frequent or painful urination occurs when a person urinates more often than is normal for him or her and when urinating causes pain, burning or stinging.
- Painful or frequent urination is most often a symptom of another condition.
- Most treatments for these conditions treat the underlying condition or include behavioral changes a person can make to feel better.
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Urinary Tract Kidney And Bladder Infections
One of the most common causes of frequent urination is a urinary tract infection, or UTI. More than half of women experience one or more UTIs in their lifetimes, many of which occur by a woman’s early 20s. UTIs are commonly caused by bacteria getting into the urinary tract from sexual intercourse or improper wiping while using the toilet. However, the frequent burning urination associated with a UTI can also occur during pregnancy, in women with immune system disorders, and from simply holding the bladder for a prolonged period of time. A specific type of UTI is a kidney infection that develops in the bladder or urethra and moves to the kidneys. If you are taking antibiotics for a UTI but your symptoms are not improving, you may have a kidney infection. Accompanying symptoms include nausea, vomiting, and blood in the urine. Most bladder infections are caused by bacteria, and these are a type of UTI. Bacteria can enter the bladder through stool and from other areas of skin through the urethra. Because women’s urethras are shorter than men’s, females are more prone to bladder infections and experience frequent urination.
What Is Urinary Urgency & Frequency
Urinary urgency is the strong, sudden desire to pass urine without prior warning, or the feeling of being busting for the toilet. Urinary frequency is defined as the need to empty the bladder often, with only short times between toilet visits. Frequency is characterised by more than ten visits to the toilet per day. Urgency and frequency may or may not be accompanied by bladder leakage or incontinence.
Urgency and frequency can cause distress for your child and your family, particularly when day-trips, shopping expeditions and car drives start to revolve around the location of toilets! Although these problems often improve with age, children do not necessarily grow out of it. The underlying bladder, muscle or nerve problem can lead to problems later in life. If your school-aged child has urinary urgency and frequency that is interrupting their quality of life, professional advice is essential.
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