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Overactive Bladder – Overview

Karyn Eilber, MD Karyn Eilber, MD February 3, 2021
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"The overactive bladder medical definition is urinary urgency or the overwhelming need to urinate with or without urge urinary incontinence, urinary frequency or urinating more than eight times in a 24 hour period, assuming no excessive fluid intake and nocturia, or urinating at night. Some reports indicate that up to one in seven women are affected by OAB and similar numbers of men are affected as well. Increasing age is a risk factor is OAB is much more common over the age of 40. The main overactive bladder symptoms of urinary urgency, frequency and urge incontinence should prompt someone to see a physician if these symptoms are bothersome, if they started abruptly, as this could be the signs of a urinary tract infection, or if they occur in a young person, as these may be the first signs of a neurologic condition. Overactive bladder causes include increasing age, post-menopause, certain neurologic diseases such as spinal cord injury, multiple sclerosis or stroke, and also prior pelvic surgeries or radiation. Complications of overactive bladder include falls from people rushing to the toilet, skin breakdown from incontinence and the use of pads, or embarrassment and decreased quality of life.

Overactive bladder is typically a clinical diagnosis based on symptom, and overactive bladder treatments follow an algorithm. The first step in the algorithm is behavioral modification. This includes decreasing excessive fluids, avoiding common bladder irritants, such as caffeine, alcohol and carbonated beverages, pelvic muscle exercises also known as Kegel exercises and timed urination. The second step in the algorithm is overactive bladder medication, with the older overactive bladder medications being anti-cholinergic medications. Common side effects of these are dry mouth and constipation. The newer overactive bladder medications may increase blood pressure slightly. And lastly, if the first two steps in the algorithm are unsuccessful, there is neuromodulation which includes regulating the nerves either behind the tibia or in the ankle or closest by itself or injection of actual Botox into the bladder muscle. If you have any other questions about overactive bladder, please visit our channel. Thank you again."

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