The cause of overactive bladder is unknown. Risk factors include obesity, caffeine, and constipation. Poorly controlled diabetes, poor functional mobility, and chronic pelvic pain may worsen the symptoms. People often have the symptoms for a long time before seeking treatment and the condition sometimes identified by caregivers. Diagnosis is based on a person’s signs and symptoms and requires other problems such as urinary tract infections or neurological conditions to be excluded. The amount of urine passed during each urination is relatively small. Pain while urinating suggests that there is a problem other than overactive bladder.
SUI happens when the pelvic floor muscles have stretched. Physical activity puts pressure on the bladder. Then the bladder leaks. Leaking my happen with exercise, walking, bending, lifting, or even sneezing and coughing. It can be a few drops of urine to a tablespoon or more. SUI can be mild, moderate or severe.
Weakness of the pelvic floor muscles and tissues that support the bladder and urethra causes stress incontinence. These muscles and tissues may be weakened by a variety of things. Some of the factors that contribute to the disorder are modifiable, and some are not. Knowledge is power. Knowing the modifiable factors is the first step toward managing the condition.
Constipation can also put extra pressure on your bladder and pelvic floor muscles so make sure you have plenty of fresh fruit, veggies and fibre in your diet. These will help your digestive system work better and help you avoid constipation
Alpha blockers. In men with urge or overflow incontinence, these medications relax bladder neck muscles and muscle fibers in the prostate and make it easier to empty the bladder. Examples include tamsulosin (Flomax), alfuzosin (Uroxatral), silodosin (Rapaflo), doxazosin (Cardura) and terazosin.
Although incontinence and continence problems have a considerable impact on a person’s quality of life, many people do not seek help. Embarrassment often prevents people talking about their bladder and bowel problems. Some people restrict going out and have little social contact outside their home.
Armstrong, C. (2013, June). AUA releases guideline on diagnosis and treatment of overactive bladder. American Family Physician, 87(11), 800-803. Retrieved from http://www.aafp.org/afp/2013/0601/p800.html
 Brubaker L, Richter HE, Norton PA, et al. 5-year continence rates, satisfaction and adverse events of Burch urethropexy and fascial sling surgery for urinary incontinence. Journal of Urology. 2012;187(4):1324–1330.
Urgency, the hallmark of OAB, is defined as the sudden compelling desire to urinate, a sensation that is difficult to defer. Urgency urinary incontinence (UUI) is urinary leakage associated with urgency. UUI is one of the most common types of urinary incontinence. Some women may have both stress urinary incontinence and UUI, and this is called mixed urinary incontinence.
You can take some steps to reduce your likelihood of developing frequent urination. You can also avoid certain foods and drinks closer to nighttime that are known to increase the likelihood of nocturia. Examples include:
There are many possible causes for being incontinent of urine, and sometimes there are several causes occurring at the same time. Diagnosis and therapy are more difficult when more than one cause is present, but the cause or causes of incontinence must be identified to provide effective treatment.
Retropubic suspension uses surgical threads called sutures to support the bladder neck. The most common retropubic suspension procedure is called the Burch procedure. In this operation, the surgeon makes an incision in the abdomen a few inches below the navel and then secures the threads to strong ligaments within the pelvis to support the urethral sphincter. This common procedure is often done at the time of an abdominal procedure such as a hysterectomy.
Urge incontinence is the leakage of urine associated with a great desire to urinate that cannot be suppressed. It is invariably associated with symptoms of urgency and frequency. The bladder is incapable of storing adequate amounts of urine, because it is either too small or unstable. There are many different causes of urge incontinence (see causes).
Nonbacterial inflammatory conditions of the bladder, including interstitial cystitis, have been associated with detrusor overactivity. Foreign bodies, including permanent sutures, bladder stones, and neoplasms, also have been linked to bladder irritability and instability.
Research projects that assess the efficacy of anti-incontinence therapies often quantify the extent of urinary incontinence. The methods include the 1-h pad test, measuring leakage volume; using a voiding diary, counting the number of incontinence episodes (leakage episodes) per day; and assessing of the strength of pelvic floor muscles, measuring the maximum vaginal squeeze pressure.
Most of us do not give the problem of frequent urination too much thought. We simply deal with it by consuming a smaller amount of water. Apart from being a source of embarrassment, this problem could interfere with your work, sleep, travel plans and general well being. While frequent urination on its own is not a major problem, it could be an indication of an underlying medical condition. Therefore, it is important to check with a doctor and determine what the possible causes of frequent urination could be. As soon as you notice this problem, it is advisable for you to check with your health care provider.
Alpha-Adrenergic Agonists: Alpha-adrenergic agonists such as clonidine and methyldopa mimic the action of norepinephrine at receptors. In this way they may contract the bladder neck, causing urinary retention and thus overflow urinary incontinence.2,16-18
Changing how much you drink. If you drink large volumes, it follows that you will pass more urine. If you have incontinence, you should not restrict your fluid intake too much, as you risk having a lack of body fluid (dehydration). Restricting fluids can also irritate the bladder and so make urge incontinence worse. However, if you drink excessively, moderation may improve your symptoms. Drinking 6-8 glasses of water per day is recommended by the NHS. However, there is no scientific evidence we should drink that much. In practical terms, it is best to drink when we need to, to quench our thirst. Remember that about one fifth of the water we take every day is hidden in food and that other drinks contain water.
Urinary incontinence. Urodynamic recording of bladder outlet obstruction due to benign prostatic hyperplasia (BPH) in a 55-year-old man. Note that during a pressure-flow study, his maximum flow rate (Qmax) is only 6 mL/s and detrusor pressure at maximum flow rate (Pdet Qmax) is very high at 101 cm H2O. He also has a small bladder capacity (50 mL) due to chronic bladder outlet obstruction. His flow curve is flat and “bread-loaf” in pattern, which is consistent with infravesical obstruction.
Spinal cord injuries interrupt the sacral reflex arc from the suprasacral spinal cord, cerebral cortex, and higher centers. These pathways are crucial for voluntary and involuntary inhibition. In the initial phase of spinal cord injury, the bladder is areflexic and overflow incontinence results. Later, detrusor hyperreflexia usually is found upon urodynamic evaluation.
An alternative theory of the mechanism of stress incontinence stems from research involving ultrasound visualization of the bladder neck and proximal urethra during stress maneuvers. This research found that 93% of patients with stress incontinence displayed funneling of the proximal urethra with straining, and half of those individuals also showed funneling at rest.  In addition, during stress maneuvers, the urethra did not rotate and descend as a single unit; rather, the posterior urethral wall moved farther than the anterior wall.