Overview

Overactive Bladder syndrome or OAB is a condition that causes a range of urinary symptoms. The most common symptom experienced by people who suffer from OAB includes a sudden and uncontrollable urge to urinate during the day and night-time.

A healthy bladder works by sending nerve signals to the brain when the bladder begins to fill with urine. These nerve signals delivered to the brain eventually trigger the urge for a person to urinate. If you have OAB, the muscles of the bladder start to contract involuntarily even when the amount of urine in the bladder is low. This involuntary contraction creates the urgent need to urinate.

Causes

OAB can be caused by:

• Neurologic disorders such as multiple sclerosis or stroke and other conditions that may have damaged the nerves that send signals between your brain and bladder.
• Diabetes
• Medications
• Urinary tract infections
• Obstructions that prevent bladder outflow including enlarged prostate and constipation
• Hormone changes
• Incomplete bladder emptying
• A urinary tract infection

Symptoms

Symptoms that may be experienced from OAB include:

• A sudden and uncontrollable urge to urinate
• Urine leakage due to the sudden and uncontrollable need to urinate (Urge incontinence)
• Stress incontinence – The thought of having an urgent need to urinate stresses you out to the point of losing water
• Frequent urination – More than eight times within 24 hours
• Waking up during the night to urinate much more than usual (Nocturia)

Treatments

• Lifestyle changes including kegel exercises, weight loss, timed visits to the toilet
• Medications
• Catheters and use of absorbent pads
• Bladder Botox® treatments
• Nerve Stimulation
• Surgery in severe cases

Kegel Exercises

Kegel exercises for men can help improve bladder control and possibly improve sexual performance. Here's a guide to doing Kegel exercises correctly.

Kegel exercises for men can strengthen the pelvic floor muscles, which support the bladder and bowel and affect sexual function. With practice, Kegel exercises for men can be done just about anytime. Before you start doing Kegel exercises, find out how to locate the correct muscles and understand the proper technique.

How to do Kegel exercises for men

To get started:

• Find the right muscles - To identify your pelvic floor muscles, stop urination in midstream or tighten the muscles that keep you from passing gas. These maneuvers use your pelvic floor muscles. Once you've identified your pelvic floor muscles, you can do the exercises in any position, although you might find it easiest to do them lying down at first.
• Perfect your technique - Tighten your pelvic floor muscles, hold the contraction for three seconds, and then relax for three seconds. Try it a few times in a row. When your muscles get stronger, try doing Kegel exercises while sitting, standing or walking.
• Maintain your focus - For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
• Repeat 3 times a day - Aim for at least three sets of 10 repetitions a day.

Urinary Incontinence

Overview

The process of urination is controlled by various muscles of the urinary system. Important muscles for urination include the muscles of the urinary bladder and sphincter muscles of urethra. In the normal process, the urine is formed in kidneys and stored in the urinary bladder. When the bladder becomes full, the bladder muscle contracts, and there is a simultaneous relaxation of urethra muscles, which lead to urination. However, in some cases, there is a urine leakage due to poor control over the bladder function. This condition of leakage is known as urinary incontinence. During urinary incontinence, the muscle of bladder contracts suddenly, due to the pressure created by sneezing, laughing and exercising, and the sphincter muscles of the urethra are unable to withstand the pressure, thereby causing leakage of urine. Urinary incontinence is common in older people as compared to young people.

What causes urinary incontinence?

Urinary incontinence may be either temporary or persistent.

Temporary urinary incontinence causes include:

• Food: Foods that stimulate the muscles of the bladder such as chocolate, artificial sweeteners, caffeine, alcohol, carbonated water, chilli or peppers, and citrus foods may also cause urinary incontinence.
• Constipation: Hard stool in the rectum may increase the frequency of urination.
• Urinary tract infection: Urinary tract infection may irritate the bladder leading to a strong urge for urination, painful urination, and urinary incontinence.
• Medications: Urinary incontinence may be caused due to various medications. These medications include diuretics used to treat hypertension, liver disease, and various kidney diseases.

Symptoms

It is to be noted that urinary incontinence itself is a symptom of underlying medical conditions either leading to damaged urinary tract muscles or functional incontinence. Urinary incontinence symptom may be accompanied by:

• Increased urination frequency particularly at night (nocturia)
• Bedwetting
• Increased urge to urinate leading to spasm in the pelvic area

Persistent urinary incontinence causes include:

• Urinary obstruction: When there is a blockage in the normal flow of urine either due to an enlarged prostate or a tumour due to stones, urinary incontinence may occur.
• Reduced control over bladder muscles: As the person ages, the involuntary contraction of bladder muscles increases. Further, control over bladder muscles also reduces with ageing.
• Pregnancy: During pregnancy, there is increasing pressure on the muscles of the urinary system due to increased fetal weight and hormonal changes. This may lead to urinary incontinence. Urinary incontinence may also be caused during childbirth due to damage of muscles required to control bladder activity.
• Surgery: Surgeries such as prostate surgery or hysterectomy may cause incontinence due to sphincteric damage or fistula formation respectively.
• Menopause: The muscular lining of the bladder and urethra are maintained by estrogen. During menopause, the level of estrogen reduces leading to poor functioning of these muscles.
• Neurological disorders: Neurological conditions such as Parkinson’s disease, Alzheimer’s disease, and multiple sclerosis affects the nerve signals of the urinary system leading to urinary incontinence.
• Connective tissue disorders: Connective tissue disorder such as Ehlers-Danlos syndrome causes problems in the muscles of the urinary system.
• Overweight: The increased weight, especially of the tummy, put pressure on the muscles of the bladder and may cause urinary incontinence.

What are the different types of urinary incontinence?

Urinary incontinence type may help to evaluate the cause of urinary incontinence and deciding the precise treatment. The types of urinary incontinence are:

• Urge incontinence: In case of urge incontinence, there is a strong urge for urination, and the people are not able to hold the urine. This leads to involuntary flow or leakage of urine. The condition may be due to diabetes or neurological disorders.
• Stress incontinence: Thus occurs when there is an extra pressure on the bladder muscles due to exercise, laughing, lifting heavy objects, coughing or sneezing, and leakage of urine occurs. The condition is especially common in middle-aged women.
• Functional incontinence: In the case of functional incontinence, although the bladder function is normal the patient is unable to go to the toilet in time. This may be due to physical disability such as arthritis or mental disorder such as Alzheimer’s disease.
• Overflow incontinence: When a patient has significant post-void residual urine small volume of urine dribbles. This condition is caused due to enlarged prostate or spine injury leading to incomplete emptying of the bladder.
• Mixed incontinence: In some cases, the patient may suffer from more than one type of urinary incontinence.