KOCHI: Overactive Bladder (OAB) is a condition that is inconvenient, embarrassing and potentially debilitating. The good news is that it can be managed. Although this condition can be treated, most patients do not seek treatment in time. OAB can cause abrupt and unstoppable need to urinate. If left untreated, it can negatively impact life by interfering in daily activities such as work, socialisation, exercise, and sleep. The incidence of OAB symptoms increases with age. Older patients are less likely to discuss their symptoms with their physician and are more likely to be untreated or under-treated.
Both men and women can get OAB. It is an under-reported problem in our country. Therefore, the exact number of cases is unknown. However, some studies mention that around 14% of men have OAB and 12 % of women have some type of urinary incontinence issue. Older women who have gone through menopause and men who have had prostate problems are more likely to get OAB. People with diseases that affect the brain or spinal cord (nervous system), such as stroke and multiple sclerosis are also vulnerable. Growing older is a factor, but not all people get OAB as they age. Therefore, it shouldn’t be considered a normal part of ageing.
Though initially mild, symptoms worsen with time and become especially bothersome in the form of severe nocturia (which badly disturbs sleep and physical and mental functioning) inability to postpone or defer the urge to urinate and leakage of urine before reaching the toilet.
Management of OAB involves a step by step approach. The basic and vital step revolves around self-management through behavioural and lifestyle changes. Oral medicines come next, progressing further to injections into the bladder wall, electrical stimulation of bladder-related nerves and finally, but very rarely, surgery.
The first step to managing OAB is lifestyle changes. Behavioural therapy is part of this. Avoiding bladder irritants such as coffee, tea, carbonated beverages and spicy food will also yield a significant symptom control. Weak pelvic floor muscles may contribute to an overactive bladder. Pelvic floor muscle exercise or Kegel exercise help reduce OAB symptoms by improving this muscular control.
Typically, medication for OAB works by calming the overactivity of the muscle in the bladder wall, thereby reducing both frequency of and unwanted urges to urination. Often oral medications work better when combined with behavioural therapy.
If lifestyle changes and medications aren’t working, there are other treatment options like injections in the bladder or nerve stimulation techniques. In a patient with OAB, the nerve signals between bladder and brain, through the spinal cord, do not communicate correctly.
Electrical pulses via nerve stimulation help set right these nerve signals to the bladder so it can function optimally and improve OAB symptoms. Only in rare and serious cases is surgery needed.
Early diagnosis and prompt treatment are proven means for reducing the severity of both symptoms and complications of OAB.