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Overactive Bladder
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By Dr. Asha Bajaj, Resident Since 1986
November is overactive bladder awareness month. Older men and women suffer from this problem, often making them feel embarrassed and withdrawing from their social activities
Experiencing occasional incontinence doesn’t mean you have an overactive bladder. Urine leakage can happen for other reasons, like if you’re laughing too hard. You may also experience loss of urine if you’ve been fighting the urge to urinate for an extended period of time.
Incontinence can occur in both men and women at any age, but it is more common among women and older people, affecting about 30% of elderly women and 15% of elderly men. Although incontinence is more common among older people, it is not a normal part of aging. Incontinence may be sudden and temporary, as when a person is taking a drug that has a diuretic effect, or it may be chronic.
An overactive bladder is determined by the frequency and urgency of urination. Symptoms include:
• an urgent and uncontrollable need to urinate
• frequent involuntary loss of urine;
• frequent urination (more than eight times in a 24-hour period)
• waking up more than once a night to use the bathroom
Urinary Sphincter
Some treatment options for overactive bladder are:
Pelvic floor physical therapy
There are physical therapists that specialize in the muscles of the pelvis. Through targeted muscle exercises and strengthening, they can help manage a variety of urinary problems, including urgency, frequency, and nighttime symptoms. These include Kegel’s exercises. To identify the pubo-coccygeal muscles, a therapist might use a vaginal cone or tampon and ask you to hold it in place. You can also exercise this muscle by stopping and controlling the flow of urine when you are voiding your bladder. Bio-feedback and electric stimulation are some other modalities available to pelvic floor specialists.
Medication
Medicines that treat overactive bladder focus on two effects: relieving symptoms and reducing episodes of urge and incontinence. These medicines include tolterodine (Detrol, Detrol LA), trospium (Sanctura), and mirabegron (Myrbetriq). These medications may cause some side effects, including dry eyes, dry mouth and constipation.
Botox
Small doses of Botox can temporarily paralyze or weaken bladder muscles. This stops them from contracting too often, which can reduce symptoms of overactive bladder. The effects of the injection typically last six to eight months, so you may need repeated treatments.
Nerve stimulation
This procedure changes the electrical signal of the nerves that carry impulses to the bladder. The electrical stimulation can be performed using a small wire inserted into the low back or a small needle inserted through the skin of the lower leg. Though it hasn’t been clearly established, some research has shown this can relieve the frequency and urgency of an overactive bladder.
Take control of the problem and do not let the problem take over your life. Get the help you need and start living your life to the fullest, get back with friends and family and manage this pesky issue once and for all.
Dr. Asha Bajaj, PT/DPT has 30+years experience in a variety of settings including the management and operation of an outpatient private practice in Walnut Creek. Asha has served in Bhutan, India, Vietnam and Malawi, Africa with Health Volunteers Overseas to train and develop their Physical therapy program. Asha has a special interest in Women’s health and did her doctoral project in the area of Bone health and Osteoporosis. Her goal is to promote health and lifelong wellness.
