|
|
| On the Run
|
| Uh-oh, you’ve got to go—right now. It’s embarrassing and can affect the way you live your daily life. Lots of women and some men suffer the indignities of an over-active bladder. Find out what you can do to help manage this troubling condition.
|
Researchers estimate that nearly 17 per cent of the general adult population in the US and Europe suffer some form of overactive bladder (OAB), a bothersome and emotionally distressing condition in which the need to urinate is sudden, urgent and frequent.
OAB is characterized by the spontaneous and compelling urge to urinate—an urge that cannot be postponed. The most predominant form of the syndrome, which doesn’t lead to urinary incontinence or leakage, is known as “OAB dry,” and is slightly more common in men.
“OAB wet” does include loss of bladder control and is slightly more prevalent in women.
Overactive bladder is not age-or-sex specific, though your risk of developing the problem increases with age.
|
|
|
Other symptoms of OAB may include frequent urination—defined as eight times or more during a 24-hour period—and nocturia, waking to urinate two or more times in a night.
Physical side effects are minimal but the psychological effects of OAB can be significant. Many sufferers experience feelings of depression, low self-esteem and as a result of their condition may withdraw from social situations to avoid further embarrassment.
“OAB greatly affects quality of life and therefore could contribute to depression (my opinion, not confirmed by data, however) but it is not associated with the development of other diseases that I know of,” offers Dr. Alan J. Wein, professor and chair, Division of Urology University of Pennsylvania Health System in Philadelphia.
While OAB does not appear to lead to more serious afflictions it may have serious consequences nonetheless. In a research paper he co-authored with Dr. Raymond Rackley, Dr. Wein cites one study that found it could contribute to fall-related injuries in elderly women.
OAB occurs when the smooth muscle fibers of the detrusor muscle of the bladder squeeze or contract at an increased rate. Normally the detrusor muscle activates when the bladder is full, signaling the need to urinate. In the case of OAB, however, the muscle contracts while the bladder is filling. A few drops might even stimulate the pressing desire to urinate.
Diagnosis includes a full history, physical evaluation and urinalysis. Many are asked to keep a bladder diary, a detailed record of eating and drinking habits and the frequency of symptoms.
Overactive bladder can occur for several reasons. Nerve damage and neurological conditions (Parkinson’s, stroke, Multiple sclerosis) are given as specific causes; constipation, urinary tract infections, bladder cancer, overactive detrusor activity, benign prostatic hyperplasia in men and pelvic organ prolapse in women constitute other causes.
Often, however, the cause for the syndrome is unknown. Most research is now focused on a looking at a possible fault in the way that the brain and bladder communicate.
Smoking and drinking too much during the day—particularly caffeine, which stimulates the bladder muscles—as well as drinking too little and alcohol consumption are all considered exacerbating factors.
Treatment for OAB is varied and includes behavioral modification therapy, pelvic floor exercises known as Kegels, and drug therapy. In extreme cases surgery to enlarge the bladder is an option.
The combination of behavior modification—keeping a bladder or urination-frequency diary, creating timed voiding regimens to counteract the sudden urge and biofeedback—with drug therapy has thus far been most successful in treating the condition.
How to Kegel: Kegel exercises are pelvic-floor exercises that may help alleviate symptoms of OAB in women. Originally developed as a control-incontinence aid for women after childbirth, they improve urethral and rectal sphincter function by strengthening the pelvic floor.
To Begin: The hardest part is finding the pelvic floor muscles. One oft-cited tip is to sit on the toilet and try to stop the flow of urine. It’s these hard-to-sense muscles that you need to strengthen.
The Movement: The basic Kegel involves squeezing the pelvic floor muscle and holding it, then relaxing it for the same amount of time. Recommendations for effective muscle strengthening range from four reps, twice a day to 10 reps, three times a day. You can sit or lie down as you perform the exercise.
|
|
|
|
|
|
|
|
