Overactive Bladder

What is overactive bladder?

By overactive bladder has been sudden strong urinary urgency, with or without incontinence ( urge incontinence ). As a rule, at the same time urge for frequent urination and need to urinate at night.

The definition implies that infections and other diseases are excluded. Overactive bladder affects both young and old. It can in most cases be handled by the practitioner.

How common is overactive bladder?

Overactive bladder is considered to be quite frequent. Many genes, but they do not seek medical advice for it. For this reason, surveys of the prevalence uncertain. But both a US and European study concludes that about 16% of people are bothered by symptoms of overactive bladder.

Since both the nocturnal urination, strong urinary urgency and frequent urination is common phenomena in the population, there is no exact dividing line between genes and disease. There is therefore no clear guidance as to when the need for treatment.

Overactive bladder occurs equally in men and women. The prevalence increases with age. Among people under 35 years, researchers found that about 7% had overactive bladder, while 30% of those over 75 had the condition.

55% of women with overactive bladder had incontinence, while the corresponding figure for men was only 16%.

What causes overactive bladder?

In many due to the symptoms of overactive bladder that signals the bladder sends to the brain is stronger than normal and starts at less bladder filling than normal. This can lead to urination reflex starts. The bladder shrinks, even if one does what one can to suppress it.

Usually, these contractions when the bladder is full and you have found a suitable place to urinate. In people with overactive bladder, this is done without that one can control it and often when the bladder is only partially filled. Why this happens is not known.

What are the consequences of overactive bladder?

The dominant issue is sudden, strong urge to urinate and the need for frequent urination. It is like 8-10 or more urination during the day and often 1-2 restroom at night.

Involuntary urination is a problem for some but not for all. Typically, it is the case that they do not manage to keep the water in connection with the strong need to urinate. He or she does not reach in time until the toilet.

Overactive bladder is a condition that can adversely affect the quality of life significantly. The condition can lead to social isolation and depression . Many fail to seek medical advice because they feel embarrassment about their genes. They fear that they have surgery, or they think the problem can not be treated because they consider it as a normal and inevitable consequence of getting older.

What are the symptoms of overactive bladder?

Suddenly irresistible urge to urinate that can lead to incontinence.

What symptoms should you pay particular attention to?

Other symptoms such as blood in the urine or pain in the bladder can be caused by a more serious disorder.

How is it diagnosed?

The doctor makes in most cases the diagnosis on the basis of medical history and by excluding other possible explanations, including by gynecological examination in women and by urine testing.

Is that the typical symptoms

• All of a sudden, strong urge to urinate, with or without incontinence
• Frequent urination
• Optionally nocturnal toileting

– the diagnosis is reasonably clear. It may be helpful for the doctor that you are some days records all your urination; for it can use a  liquid / voiding diary .

Additional studies are usually unnecessary. If the doctor is unsure of the diagnosis, it may be necessary to perform so-called urodynamic studies, which test bladder function and perhaps a telescopic examination of the bladder

The vast majority of people with overactive bladder can be evaluated and treated by the family doctor. But the uncertainty about the diagnosis or treatment, or poor treatment effect, can be referred to a specialist in urinary tract disorders (urologist) or female diseases (gynecologist).

At some hospitals are called uroterapeuter. They have expertise in handling urology and can give good help.

What treatment is there?

The goal of treatment is to reduce symptoms. There are no clear guidelines as to when to be given active treatment. For many patients, information about the condition sufficient treatment, so treatment with medication is not necessary.

The strong urge to urinate (pee) is the central symptom. People with this and other pronounced symptoms like incontinence have reduced quality of life. The symptoms are annoying in daily life.

You have to assess whether you need medication. Along with the physician must evaluate the need for therapy against the efficacy, safety, cost and willingness to use medications over time. The medication helps the symptoms but do not treat the underlying mechanisms. So it does no harm to refrain from medical treatment.

For patients with severe symptoms and poor or lack of affect of medicine, there are now also other treatment options. Botulism toxin (Botox) can be injected into the bladder muscle, and thus in part the lamb for a while.

There are also developed various types of electro-stimulation , which can dampen bladder activity.

What can you do yourself?

The simplest and in many cases the only treatment needed is bladder training . This means that you train the bladder to “last longer” before going to the toilet and pee.

You can create your own training program, where you gradually increase the time to the next toilet. This allows the urinary bladder get used to accommodate more urine. Thereby you do not urinate as often. People with incontinence can benefit from pelvic floor exercises and electrical stimulation.

Medical treatment

If you and your doctor have agreed that there is good reason to seek medical treatment, you use medicines called muskarinreceptorantagonister or beta-3 adrenoceptor agonists. This type of medicine blocks a portion of the nervous activity of the urinary bladder, in particular in the phase in which the bladder fills up. The damper in this way the urge to urinate, reducing the need to urinate. The medicine affects poorly emptying of the bladder.

Medications of muscarinic receptor antagonist type should be used with caution in elderly people. Studies of elderly patients shows yet that the drugs are generally well tolerated.

The are several muskarinreceptorantagonistpræparater – darifenacin, fesoterodine, oxybutinin patch, solifenacin, tolterodine and trospium chloride and a single beta-3 adrenoceptor agonist – Mirabegron. Studies indicate that these compositions approximate works well of overactive bladder. They give:

• less genes
• Decreases the number of urination
• Resulting in fewer episodes of incontinence
• Increases bladder volume before any urge to urinate
• Increases the maximum volume of the bladder

Among scientists there is some debate as to how good the compositions are. Many people with overactive bladder is happy effect on their genes.

One can expect effect within a month. The treatment can be used over a long time. The effect does not seem to decrease with time.

The most common side effects of muskarinreceptorantagonister are dry mouth, constipation and tend to blurred vision. Effects are normally mild to moderate. These side effects are less at Mirabegron.

The side effects are usually acceptable, but can lead to that you have to stop the medication. When you get freedom to adjust the dose, and thus find out what is the best dosage for you, the treatment to be more acceptable.

The best treatment effect is achieved with a combination of bladder training and treatment with medication.

How is long-term prospects?

It is a chronic condition. With proper treatment, you can get good control over your genes and live well with it, you may have the genes.

How do I avoid or worsen overactive bladder?

By trying to train your ability to suppress the urge to urinate.