Activities may also increase the risk of OAB if they weaken or damage the pelvic floor, urinary, or sphincter muscles. Conditions that limit the use of pelvic and abdominal muscles may have the same effect.
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The guidelines provide an informed framework for selecting appropriate behavioral, pharmacologic, and surgical treatment and supportive services that can be used to treat urinary incontinence. The panel concluded that behavioral techniques such as bladder training and pelvic muscle exercises are effective, low cost interventions that can reduce incontinence significantly in varied populations. Surgery, except in very specific cases, should be considered only after behavioral and pharmacologic interventions have been tried. The panel found evidence in the literature that treatment can improve or cure urinary incontinence in most patients. The address of the AHCPR is Agency for Health Care Policy and Research, P.O. Box 8547, Silver Spring, MD 20907. They can also be called toll free at (800) 358-9295.
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Urinary incontinence refers to a loss or leaking of urine due to faulty bladder control. An estimated 25% to 33% of people in the United States suffer from urinary incontinence. That means millions of people live with the condition. There are many different types of urinary incontinence. Although both men and women suffer from the condition, several factors unique to women increase the risk of urinary incontinence in females. It’s a common misconception that this is a normal part of aging. It is not. Thankfully, there are lots of ways to manage urinary incontinence and minimize the effect it has on your life.
Mishra GD, Barker MS, Herber-Gast GC, Hillard T. Depression and the incidence of urinary incontinence symptoms among young women: Results from a prospective cohort study. Maturitas. 2015 Aug. 81 (4):456-61. [Medline].
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.
This involves learning techniques that help retrain your bladder, and gradually increase the time between visits to the toilet. It usually takes about 6- 12 weeks to retrain yourself to hold urine longer and to pass urine less frequently.
Another risk factor for frequent urination is pregnancy. The growing uterus can place extra pressure on the bladder during pregnancy. As a result, a woman may have to go to the bathroom more frequently.
Another possible explanation for detrusor overactivity in a subgroup of patients involves the triggering of the micturition reflex by leakage of urine into a funneled and partially incompetent proximal urethra. This theory is consistent with the findings of detrusor overactivity caused by coughing or changing position.
The bladder is made of muscle and stores the urine. It expands like a balloon as it fills with urine. The outlet for urine (the urethra) is normally kept closed. This is helped by the muscles below the bladder that surround and support the urethra (the pelvic floor muscles).
Like caffeine, alcohol is a diuretic and a bladder irritant. So drinking a beer is a triple whammy, because you’re consuming liquid, accelerating the rate at which your kidneys are gathering water, and forcing the bladder to empty more often. Dr. Winkler advises his overactive-bladder patients who drink alcohol to stick to a single glass of wine or liquor per day.
Urinary frequency may be accompanied by a sensation of an urgent need to urinate (urinary urgency). Many people particularly notice polyuria because they have to get up to urinate during the night (nocturia). Nocturia also can occur if people drink too much fluid too close to bedtime, even if they drink no more than normal overall.
Overactive bladder (OAB) is a bladder disorder that results in an abnormal urge to urinate, urinary frequency, and nocturia (voiding at night). Some patients may also experience urinary incontinence (involuntary loss of bladder control).
An OAB occurs when the bladder squeezes (contracts) suddenly without you having control and when the bladder is not full. OAB syndrome is a common condition where no cause can be found for the repeated and uncontrolled bladder contractions. (For example, it is not due to a urine infection or an enlarged prostate gland.)