April 23, 2014
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Bladder (Overactive)

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Overactive Bladder

(OAB)

Diagnosing Overactive Bladder

To make a diagnosis of OAB, the doctor needs to first take a full medical history and rule out other possible causes of your symptoms. Other conditions, such as urinary tract infections or UTIs, certain inflammations of the vagina, multiple sclerosis, bladder stones, and diabetes, may cause symptoms similar to OAB. The doctor needs to rule these out by ordering laboratory tests to check for such things as increased blood sugar levels or signs of infection in the urine.

If the doctor suspects you have OAB, you may be asked to keep a diary over at least a three-day period to determine how many times a day you empty your bladder. Your doctor will diagnose you with OAB when all other possible causes of your symptoms are ruled out and OAB is the most likely explanation.





Treating and Preventing Overactive Bladder

Prevention

Prevention of OAB is based on making certain changes in your lifestyle. Eating a healthy high-fibre diet, which reduces risk for constipation, and limiting intake of caffeine and alcohol will reduce the risk of OAB. If you find that certain medications have increased your urge to empty your bladder, you should discuss this with your doctor. Do not stop taking any medications without talking to your doctor.

Treatment

There are many effective treatments for OAB.

Non-medication treatment options include:

Kegel or pelvic floor retraining exercises - These exercises teach you how to strengthen the muscles of the pelvic floor. By contracting the muscles that support the bladder, you strengthen and tighten the bladder outlet. These exercises need to be done on a regular basis and as discussed with your health professional in order for them to be successful.

Bladder training or bladder drill - By gradually increasing the time between each visit to the bathroom you may be able to train your bladder so that the urge to urinate does not occur as often. Your doctor will provide education on this technique and how to schedule your bathroom visits. While you are doing this, your doctor may ask you to reduce your fluid intake. Always discuss any change of fluid intake with your doctor.

Surgery - Those who don't experience relief from OAB with medications or other treatments may benefit from surgery. Surgery may be aimed at reducing the nerve stimulation that causes the involuntary contractions of the bladder, increasing the size of the bladder, or creating a different pathway for urine to be drained.

Medications* for OAB include:

Antimuscarinic (antispasomodic) medications - Antimuscarinic medications are the first choice for medication treatment of OAB. These medications reduce the number of involuntary bladder contractions by preventing spasm of the detrusor muscle that causes them. In general, these medications can reduce leakage of urine caused by OAB by 60% to 75%. Examples of antimuscarinic medications include:

  • darifenacin
  • oxybutynin
  • solifenacin
  • tolterodine
  • trospium

The most common side effects of antimuscarinic medications are dry mouth and constipation. Be sure to tell your doctor about all of the medications you are taking and all of your medical conditions, as there are some people who should not take antimuscarinic medications.

Other medications - Medications known as tricyclic antidepressants (e.g., amitriptyline, imipramine) and calcium channel blockers (e.g., nifedipine, diltiazem) have been used with mixed results in the treatment of OAB.


*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.

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This condition and disease information is written and reviewed by the MedBroadcast Clinical Team.

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