Overactive bladder

Overactive bladder (OAB) is a common condition where there is a frequent feeling of needing to urinate to a degree that it negatively affects a person's life. Overactive bladder is characterized by a group of four symptoms: urgency, urinary frequency, nocturia, and urge incontinence. Urinary frequency is defined as urinating more than about 7-8 times in one day. The frequent need to urinate may occur during the day, at night, or both. The number of episodes varies depending on sleep, fluid intake, medications, and up to seven is considered normal if consistent with the other factors. In addition, patients with OAB experience urinary urgency, a sudden feeling that they have to get to the bathroom very quickly. Lastly, they may experience nocturia, which is waking up at night to urinate. Loss of bladder control (urge incontinence) is a form of urinary incontinence characterized by the involuntary loss of urine occurring for no apparent reason while feeling urinary urgency as discussed above, and often occurs with this condition. This condition is also sometimes characterized by a sudden and involuntary contraction of the bladder muscles, in response to excitement or anticipation. OAB is distinct from stress urinary incontinence (SUI), but when they occur together, the condition is usually known as mixed urinary incontinence.…

Overactive bladder (OAB) is a common condition where there is a frequent feeling of needing to urinate to a degree that it negatively affects a person's life. Overactive bladder is characterized by a group of four symptoms: urgency, urinary frequency, nocturia, and urge incontinence. Urinary frequency is defined as urinating more than about 7-8 times in one day. The frequent need to urinate may occur during the day, at night, or both. The number of episodes varies depending on sleep, fluid intake, medications, and up to seven is considered normal if consistent with the other factors. In addition, patients with OAB experience urinary urgency, a sudden feeling that they have to get to the bathroom very quickly. Lastly, they may experience nocturia, which is waking up at night to urinate. Loss of bladder control (urge incontinence) is a form of urinary incontinence characterized by the involuntary loss of urine occurring for no apparent reason while feeling urinary urgency as discussed above, and often occurs with this condition. This condition is also sometimes characterized by a sudden and involuntary contraction of the bladder muscles, in response to excitement or anticipation. OAB is distinct from stress urinary incontinence (SUI), but when they occur together, the condition is usually known as mixed urinary incontinence. Treatment of mixed urinary incontinence usually focuses on the more bothersome component between OAB and SUI. Overactive bladder affects approximately 11% of the population and more than 40% of people with overactive bladder have incontinence. Conversely, about 40% to 70% of urinary incontinence is due to overactive bladder. Overactive bladder is not life-threatening, but most people with the condition have problems for years. ===Lifestyle and behavioral therapy=== Behavioral and lifestyle changes are commonly recommended as the first-line option for treating overactive bladder. These include bladder training, which involves scheduled voiding (urination) and gradually increasing the time between bathroom visits. Pelvic floor exercises, known as Kegel exercises, can help strengthen the muscles that control urination. Fluid management, which focuses on avoiding excessive caffeine and alcohol intake, is advised to reduce the rate at which the bladder fills and minimize irritation to the bladder. Weight management and maintaining a healthy diet contribute to overall bladder health, especially when weight loss is able to reduce abdominal compression of the bladder. Adopting these behavioral and lifestyle changes can often improve the condition and enhance the effectiveness of other treatment approaches. Most people are not able to eliminate incontinence and other symptoms of OAB with lifestyle and behavioral modifications alone. However, numerous studies have demonstrated that these therapies are effective in improving quality of life, and some data shows that they increase the likelihood that medications can keep the OAB under control. ===Medications=== Medications are a common treatment option for people with overactive bladder syndrome. A number of antimuscarinic drugs (e.g., darifenacin, hyoscyamine, oxybutynin, tolterodine, solifenacin, trospium, fesoterodine) are frequently used to treat overactive bladder. Long term use, however, has been linked to dementia. β3 adrenergic receptor agonists (e.g., mirabegron, vibegron) may be used, as well. Patients taking Oxybutynin and other anticholinergic drugs experience a 70% reduction of incontinence episode frequency, on average. Approximately 1 in 4 patients experience complete dryness while taking oxybutynin. Therefore, medication management alone is sufficient for a substantial minority, but not the majority, of patients with overactive bladder. ==Prognosis== Because overactive bladder is most commonly associated with aging, the majority of patients experience symptoms (with or without incontinence) for the rest of their lives. A minority of age-related OAB cases may be cured or indefinitely suppressed by medications and behavioral modification. If the OAB is due to a different condition, such as a urinary tract infection, then symptoms should resolve after the underlying problem has been treated. ==Epidemiology== Earlier reports estimated that about one in six adults in the United States and Europe had OAB. The number of people affected with OAB increases with age, thus it is expected that OAB will become more common in the future as the average age of people living in the developed world is increasing. However, a recent Finnish population-based survey suggested that the number of people affected had been largely overestimated due to methodological shortcomings regarding age distribution and low participation (in earlier reports). It is suspected, then, that OAB affects approximately half the number of individuals as earlier reported. The American Urological Association reports studies showing rates as low as 7% to as high as 27% in men and rates as low as 9% to 43% in women. Urge incontinence was reported as higher in women. Older people are more likely to be affected, and the number of symptoms increases with age.

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