If your daily schedule is becoming dictated by frequent and sudden urinary urges that leave you scrambling for the nearest bathroom, it might be time to ask a doctor about overactive bladder.
Overactive bladder is a broad term that describes certain symptoms: urinary urgency, frequent urination, waking up at least twice a night to urinate, or urge incontinence (leakage of urine).
“It’s pretty straightforward. It’s really a diagnosis based on symptoms,” says Donna Y. Deng, MD, MS, a urologist and associate professor at the University of California-San Francisco who also serves on the board of directors at the National Association for Continence. But patients need not have all four signs to be diagnosed, she says.
How is OAB diagnosed?
Many types of doctors can diagnose and treat overactive bladder. “The majority that come across this will be primary care doctors, internal medicine, and obviously, urologists and gynecologists,” Deng says.
Treatment is important because overactive bladder can seriously interfere with activities, Deng says. Patients may need to pull off the freeway immediately to find a restroom, or they will map out every public bathroom before they run errands. Some fear leaving their homes and become isolated. “People really redefine themselves,” Deng says. “They really plan their lives around the bathroom. It’s definitely a great detriment to quality of life.”
In some cases, the urge is so strong that people can’t reach a toilet in time. “There’s very little warning time,” Deng says.
Talking about overactive bladder
Talking about such personal issues can be uncomfortable, but worthwhile, experts say. “Patients often don’t volunteer information,” says Tomas L. Griebling, MD, MPH, professor and vice chair of the department of urology at the University of Kansas and a faculty associate in the Landon Center on Aging. “A lot of people…stop being sexually active because of incontinence and leaking and often are reluctant to discuss that.”
Tell your doctor about such problems, he says. “There are usually things that we can do to try to help people.”
Urge incontinence versus stress incontinence
Not everyone with overactive bladder will have incontinence, a problem in which urine leaks. But doctors do check for symptoms of stress incontinence and urge incontinence. If a patient has urge incontinence, it’s more likely to point to overactive bladder.
Also, “you need to make a clear distinction because the treatments are very different,” Deng says.
With stress incontinence, people leak urine when they cough, laugh, or sneeze. “People leak urine with physical activities that increase the pressure inside the abdomen,” Griebling says. Stress incontinence can begin when pelvic muscles weaken, for example, after pregnancy and childbirth.
With urge incontinence, “people actually have that sensation of needing to go very quickly, but leak urine before they can reach the toilet,” Griebling says. Typically, the sense of urgency stems from involuntary contractions of the bladder muscles.
