Do you immediately scope out the bathroom in unfamiliar places? Have you ever watched a movie straight through without stopping? Do you know the location of every restroom between your home and work?  Overactive bladders (OAB) are nothing to sneeze at (literally!).  For clinical purposes, eight or more urinations per day is the hallmark of an overactive bladder.  Nerves and muscles in the bladder are the major players in bladder dysfunction.  The nervous system is responsible for regulating the contraction and relaxation of bladder muscles.  The constant urge to urinate all the time is the result of inappropriate contractions.  Common causes of inappropriate contractions are:

• Spinal cord injuries
• Diabetes
• Parkinson’s Disease
• Dementia
• Multiple Sclerosis
• Urinary tract infections
• Anxiety

Along with medication prescribed by a physician, OAB patients can also manage their symptoms with behavioral therapy, electrical stimulation, pelvic floor exercises, fluid management, urination schedules and bladder training.  Avoid caffeine and alcohol because both substances are diuretics and stimulate the bladder.

An estimated 15% of the United States population will suffer from overactive bladders.  Worldwide, 200 million people are affected.  Although prevalence increases with age, young people are not immune.  OAB occurs twice as often in women than in men.  Roughly, one in five adults over the age of 40 experience overactive bladders.  It takes women about 6.5 years to seek treatment after the first episode.   Unfortunately, there is a stigma associated with overactive bladders and embarrassment may prevent treatment.  The number of adults with overactive bladders is likely underreported because of failure to seek treatment.

The Urology Care Foundation has launched a public education campaign to reduce the stigma and shame of frequent urination.  If you’re experiencing frequent or excessive urination, talk with your doctor about the possibility of treatment.  Ask about symptoms, testing and treatment.  Writing down questions beforehand may help you feel less uncomfortable about broaching the subject.  Don’t accept this as a way of life.  Take control.

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Overactive Bladder: What’s Going Wrong with your Urinary System?

The human body’s urinary system is made up of just a few organs that do a very important job. They are responsible for removing waste from the body and keeping chemical levels in balance.

Of course, urinating is a very personal and “hush-hush” topic. When individuals run into trouble with their urinary system, they are often reluctant to seek help. However, urinary issues, especially overactive bladder, are very common and easily treatable

The Main Players

You are probably well aware of the kidneys and the bladder. In addition to these organs, the urinary system also includes two ureters (tubes that connect the kidneys to the bladder) and the urethra (a tube that carries urine out of the body).

The urinary system is also quite dependent on muscles and nerves. As the bladder is approaching its capacity, nerves in the bladder send a signal to the brain, letting the body know that it will need to be emptied soon. This sensation becomes stronger as the bladder fills to the brim.

When you arrive at the bathroom, the brain tells the bladder muscles to contract and tighten. At the same time, the brain is also telling a set of other muscles, the sphincter muscles, to loosen. These muscles usually keep the opening of the bladder tightly closed, but when you are urinating, the brain allows them to loosen.

So, in order to urinate, the brain instructs the bladder muscles to tighten and tells the sphincter muscles to loosen. These two actions result in urine being  squeezed into the urethra and out of the body.

Normally, adults can expect to urinate 4-7 times per day and once at night. That adds up to a quart and a half of urine. Of course, these amounts may vary based on the amount of food and drink you consume.

What’s Going Wrong?

Estimates vary widely, but according to The Urology Care Foundation, nearly 33 million Americans have overactive bladder. Individuals with this disorder don’t have full control over their bladder functions. Urine often comes out at the wrong times.

Three main symptoms are involved in overactive bladder:

1. Frequent urination, often more than eight times per day or more than once at night
2. A strong, sudden urge to urinate
3. Leaking urine

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Overactive bladder may happen for a number of reasons. In some people, the nerves of the bladder send faulty signals to the brain. The bladder isn’t full, but it tells the brain that it needs to be emptied. In others, the muscles of the bladder are overactive. They involuntarily contract at the wrong times and send a strong, urgent signal to force the urine out of the body.

The underlying cause of overactive bladder varies greatly from person to person.

• Medications and alcohol can lull the nerve signals sent between the brain and the urinary system.
• Caffeine and water pills can cause the bladder to fill extremely quickly.
• Weak muscles in the pelvic floor may not be able to hold up the bladder or the urethra.
• Neurological disorders can cause damage the nerve pathways.

Both men and women, old and young, have overactive bladder. Although many people perceive overactive bladder as an embarrassing condition, there is no need to hide your symptoms. Several potential treatments are available. If you suspect that you have overactive bladder, make an appointment with your doctor and voice your concerns.

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