Living with an Overactive Bladder

Although overactive bladder can be treated, more than 80% of affected women do not seek treatment.

In the United States, an estimated 33 million individuals suffer from the bothersome symptoms associated with overactive bladder (OAB), which is a common condition affecting 30% of men and 40% of women.1 OAB is characterized as a syndrome that causes an abrupt and unstoppable need to urinate, and it is considered to be one of the top 10 chronic medical issues that affect women between 45 and 64 years of age.^2,3

Although OAB can be effectively treated, unfortunately more than 80% of women with OAB symptoms do not seek treatment, possibly because of embarrassment or because of a belief that OAB is due to the aging process.² Contrary to popular belief, OAB is not a normal part of aging, but the risk of developing OAB symptoms increases with aging.⁴ Left untreated, OAB can negatively impact your life by interfering in daily activities such as work, social activities, exercise, and sleep.

Causes and Risk Factors

The cause of OAB is still unknown; however, research has determined that OAB symptoms are the result of the bladder’s inability to relax and hold more urine.^1,2 OAB occurs when the nerve signals between your brain and your bladder alert your bladder to empty, even when it is not full or when the bladder muscles contract while the bladder is still filling.^1,2 Men and women are at risk for OAB, but some risk factors may increase an individual’s chance of developing OAB.

According to the American Urology Association, women who are postmenopausal and men who have had prostate issues appear to be at greater risk for developing OAB. In addition, those with neurologic conditions such as multiple sclerosis, those who have had a stroke, and those with diabetic neuropathy have a greater risk of developing OAB.⁶ Diets high in foods and drinks that can irritate the bladder (eg, spicy foods, caffeine, alcohol) can worsen or aggravate OAB symptoms in some individuals.^5,6

Symptoms

OAB may involve a variety of symptoms, such as:

• Urinary urgency: the inability to postpone the need to urinate
• Frequent urination: the need to urinate at least 8 times per day
• Urge incontinence: leakage of urine when an individual has the urge to urinate
• Nocturia: the need to interrupt sleep to urinate at least 2 times during the night

Diagnosis

If you suspect that you have OAB or if you are experiencing any of the symptoms associated with OAB, it is important that you see your primary health care provider for a thorough evaluation. Your health care provider will ask you questions about your symptoms, diet, and medical and medication histories. An examination and tests may be required to determine the cause of your symptoms.

Treatment

If you are given a diagnosis of OAB, your health care provider will determine the best treatment for you. Various measures can be taken to help you effectively manage and treat OAB. Treatment generally involves a combination of therapies, which may include lifestyle and dietary modifications, drug therapy, and behavior modifications. In 2013, the FDA approved Oxytrol for Women, a patch manufactured by MSD Consumer Care, Inc. This product became the first nonprescription treatment for OAB. In May 2014, AZO Bladder Control with Go Less (iHealth Inc), a drug-free dietary supplement, became available to manage OAB symptoms.

In addition, several prescription medications can be used to treat OAB. These medications, which are available in oral and topical formulations, relax the bladder and prevent it from contracting at the wrong time.^1,3 The most common types of medications prescribed for the treatment of OAB include antimuscarinic medications and a relatively new medication that is classified as a beta-3 adrenergic agonist.³ Your health care provider will determine which medication, if any, is best for you. Your pharmacist will provide you with information about the medication, including its dosing and potential adverse effects.

Behavioral therapy techniques that may be used for OAB include bladder retraining and pelvic floor therapy exercises. Dietary changes that may help decrease or alleviate OAB symptoms include eliminating or decreasing your intake of tea, coffee, alcohol, chocolate, citrus juices, spicy or acidic foods, and foods or drinks that contain artificial sweeteners. Because smoking and excess weight can worsen OAB symptoms, it can help to maintain a healthy weight and stop smoking.

Living with OAB

Left untreated, OAB can negatively impact an individual’s life by causing embarrassment, depression, stress, and anxiety. But the good news is that with proper treatment, you can take control of OAB and live a healthy, active life without worrying about OAB symptoms. It is important to adhere to the recommended therapy, maintain routine visits with your primary health care provider to discuss your concerns, and immediately seek medical care if your condition worsens or any adverse effects develop. See Online Table 1 for patient education resources on OAB.

Table 1: Educational Resources for Overactive Bladder

• Bladder control: what women need to know. National Kidney and Urologic Diseases Information Clearinghouse website: http://kidney.niddk.nih.gov/kudiseases/pubs/bladdercontrol_ES/index.aspx

• It’s time to talk about OAB. Urology Care Foundation website: www.urologyhealth.org/oab/oab_ques.cfm

Ms. Terrie is a clinical pharmacist and medical writer based in Haymarket, Virginia.

References

• Overactive bladder (OAB). Urology Care Foundation website. www.urologyhealth.org/urology/index.cfm?article=112. Accessed May 6, 2014.
• What is overactive bladder? Oxytrol website. www.oxytrolforwomen.com/what-is-overactive-bladder.html. Accessed May 6, 2014.
• Overactive bladder. Medscape website. http://emedicine.medscape.com/article/459340-overview. Accessed May 6, 2014.
• Overactive bladder. Medline Plus website. www.nlm.nih.gov/medlineplus/overactivebladder.html. Accessed May 6, 2014.
• Causes of overactive bladder. National Association for Continence website. www.nafc.org/urge-incontinence/causes-of-oab. Accessed May 6, 2014.
• It’s time to talk about OAB. Urology Care Foundation website. www.urologyhealth.org/oab/patients.cfm. Accessed May 6, 2014.