There you are in a deep sleep when it happens again: Themounting pressure on
your bladder, the sensation to urinate, the inability to avoid leaking a little
before making it to the bathroom. It happens several times a night. And you may
have been living with this discomfort and inconvenience for years.
This frequent urge to urinate during the night or day, perhaps even to the
point where it?s almost impossible to "hold it," may be due to an
overactive bladder. According to the American Foundation for Urologic Disease,
overactive bladder affects about one out of every 11 adults, and this is likely
an underestimate because many people are too embarrassed to talk about the
problem with their doctor. Some people also will leak urine when they feel the
urge to urinate, a condition called urge incontinence.
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The condition often affects sleep quality, but it can be just as troubling
during the day. "This translates to someone who can't go an hour or two
without urinating, someone who constantly searches for bathrooms and plans
outings based on this," says Kenneth Goldberg, MD, a Dallas urologist.
"It's a problem that has serious impacts on lifestyle and quality of life.
Some people are miserable. Most of the time, we really don't know why it's
Bleak as this may sound, there's hope -- in the form of treatments and
common-sense measures that can make life nearly normal again, or at least
Although researchers have not been able to nail down a single cause, some
things are known. The symptoms of overactive bladder can be the sign of an
underlying problem such as a urinary-tract infection. When the infection is
treated, symptoms will clear. But in many other cases, overactive bladder
occurs when no other illnesses can explain it.
For instance, the condition is associated with aging, says Wendy Leng, MD, a
urologist at the University of California at San Francisco Medical Center.
"Just as with other parts of the body, with wear and tear, the bladder just
doesn't perform its function as well as it used to."
Men with prostate conditions are more likely to have problems with
urination. With women, postmenopausal hormonal changes, which can weaken tissue
tone, and childbearing can play a role. "Clearly there's a relationship
between having kids and being incontinent," says Gary Leach, MD, a
urologist at Cedars-Sinai Medical Center in Los Angeles. This may be due to the
downward pressure of the fetus pushing on the bladder, or to the vaginal birth
process, which can damage muscles and nerves near the bladder and urethra, he
The most important step in finding the right treatment -- and getting life
back to normal -- is receiving an accurate diagnosis. If your primary care
doctor can't determine what is causing problems, the next step is to see a
urologist. The specialist will test the blood and urine and may also perform
other tests, checking for infection, cancer, and other illnesses associated
with urinary problems.