Overactive Bladder is a Common – But Treatable – Health Issue

LEXINGTON, Ky. (Oct. 27, 2014) -- People often joke about how many times they have to urinate, especially after drinking caffeine-laden beverages or a lot of water. But having a true overactive bladder is a serious – and for many patients, an awkward and uncomfortable – health problem.

Overactive bladder is defined as urinary urgency, usually with frequent urination and nighttime urination (known as "nocturia"). It may or may not involve urge urinary incontinence, which is a strong, immediate need to urinate followed by the involuntary loss of urine.

Overactive bladder is a symptom complex that is potentially caused by several diseases or conditions. It may be the result of several factors including infection, inflammation, obstruction, neurologic disease and/or psychologic issues.

Overactive bladder is estimated to affect 12-17 percent of Americans and Europeans, with likelihood of the condition increasing with age.  The prevalence of overactive bladder appears to be similar between men and women; however, women are more likely to experience urge incontinence.

Many patients are reluctant to discuss symptoms of overactive bladder with their physicians due to embarrassment. Additionally, many patients are not aware that there are treatment options and just assume it is a normal part of aging that they must deal with.

However, there are several options for the management and/or treatment of overactive bladder, including:

• Behavioral and lifestyle modifications including weight loss, dietary changes and fluid management. For example, avoiding spicy foods, artificial sweeteners, caffeinated beverages and/or simply drinking less in one sitting may help.

• Bladder retraining, pelvic floor muscle exercises (like "quick flick" Kegels) and/or biofeedback therapy (using measuring devices to become more aware of and control bodily functions).

• Medications.

Neuromodulation including percutaneous tibial nerve stimulation (PTNS) or sacral nerve stimulation (SNS). PTNS is a series of office treatments involving a tiny needle electrode that stimulates a nerve near the ankle. The stimulation travels back to nerves in the spinal cord that help control the bladder. SNS works via a surgically implanted pacemaker for the bladder and is designed to imitate a signal sent through the central nervous system.

Botox injections. Though Botox is well-known as a cosmetic procedure meant to reduce the appearance of wrinkles, it can be used for a variety of health issues, and it was recently approved by the Food and Drug Administration (FDA) as a treatment for overactive bladder. Botox injections inhibit muscle contractions, which can help reduce the urge to urinate. Injections can be performed as an office procedure  under local anesthesia.

In short, patients with bothersome urinary symptoms need to know that overactive bladder is a common issue among both men and women, and one should never be embarrassed or ashamed to seek help from a medical professional. Multiple treatment options are available and could make a huge difference in your quality of life.

Dr. Katie Ballert is a urologist  board certified in Female Pelvic Medicine and Reconstructive Surgery at UK HealthCare.

This column appeared in the October 26, 2014 edition of the Lexington Herald-Leader