Female Urology  

OVER ACTIVE BLADDER (OAB)

Overactive bladder (OAB) is the name for a group of urinary symptoms. It is not a disease. The most common symptom is a sudden, uncontrolled need or urge to urinate. Some people will leak urine when they feel this urge. Another symptom is the need to pass urine many times during the day and night. OAB is basically the feeling that you’ve “gotta’ go” to the bathroom urgently and too much.

As many as 40 percent of women in the United States live with OAB symptoms. Many people living with OAB don't ask for help. They may feel embarrassed. Many people either don't know how to talk with their health care provider about their symptoms, or they think there aren't treatments that can help.

Symptoms

Urgency: The major symptom of OAB is a sudden, strong urge to urinate that you can't ignore. This "gotta go" feeling makes you fear you will leak if you don't get to a bathroom right away. You may or may not actually leak with this urge to go.

If you live with OAB, you may also:

Leak urine or have “urge incontinence.” This means urine leaks when you feel the sudden urge to go. This isn’t the same as stress urinary incontinence or SUI . People with SUI leak urine when sneezing, laughing or doing other physical activities.

Urinate frequently. You may need to go to the bathroom many times during the day. The number of times someone urinates varies from person to person. Many experts agree that going to the bathroom more than eight times in 24 hours is “frequent urination.”

Wake up at night to pass urine. If you have to wake from sleep to go to the bathroom more than once a night, it’s a symptom of OAB or nocturia.

Causes

Normally, when your bladder is full of urine waste, your brain signals the bladder. The bladder muscles then squeeze. This forces the urine out through the urethra. The sphincter in the urethra opens and urine flows out. When your bladder is not full, the bladder is relaxed.

With a healthy bladder, signals in your brain let you know that your bladder is getting full or is full, but you can wait to go to the bathroom. With OAB, you can’t wait. You feel a sudden, urgent need to go. This can happen even if your bladder isn’t full.

If the nerve signals between your bladder and brain don’t work properly, OAB can result. The signals might tell your bladder to empty, even when it isn't full. OAB can also be caused when muscles in your bladder are too active. This means that the bladder muscles contract to pass urine before your bladder is full. In turn, this causes a sudden, strong need to urinate. We call this "urgency."

URINARY INCONTINENCE

Urinary incontinence is leaking of urine that you can't control. Many American men and women suffer from urinary incontinence. We don't know for sure exactly how many. That's because many people do not tell anyone about their symptoms. They may be embarrassed, or they may think nothing can be done. So they suffer in silence.

Urinary incontinence is not just a medical problem. It can affect emotional, psychological and social life. Many people who have urinary incontinence are afraid to do normal daily activities. They don't want to be too far from a toilet. Urinary incontinence can keep people from enjoying life.

Many people think urinary incontinence is just part of getting older. But it's not. And it can be managed or treated. Learn more here. Talk to your doctor. Find out what treatment is best for you.

A quarter to a third of women in the U.S. suffer from urinary incontinence. That means millions of Americans. About 33 million have overactive bladder (also known as OAB) representing symptoms of urgency, frequency and with or without urge incontinence.

What are the types of urinary incontinence?

Urinary incontinence is not a disease. It is a symptom of many conditions. Causes may differ for men and women. But it is not hereditary. And it is not just a normal part of aging. These are the four types of urinary incontinence:

Stress Urinary Incontinence (SUI)

With SUI, weak pelvic muscles let urine escape. It is one of the most common types of urinary incontinence. It is common in older women. It is less common in men.

SUI happens when the pelvic floor muscles have stretched. Physical activity puts pressure on the bladder. Then the bladder leaks. Leaking my happen with exercise, walking, bending, lifting, or even sneezing and coughing. It can be a few drops of urine to a tablespoon or more. SUI can be mild, moderate or severe.

Mixed Incontinence (SUI and OAB)

Some people leak urine with activity (SUI) and often feel the urge to urinate (OAB). This is mixed incontinence. The person has both SUI and OAB.

Overflow Incontinence

With overflow incontinence, the body makes more urine than the bladder can hold or the bladder is full and cannot empty thereby causing it to leak urine. In addition, there may be something blocking the flow or the bladder muscle may not contract (squeeze) as it should.

One symptom is frequent urinating of a small amount. Another symptom is a constant drip, called "dribbling."

This type of urinary incontinences is rare in women. It is more common in men who have prostate problems or have had prostate surgery.

INTERSTITIAL CYSTITIS

Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a chronic bladder health issue. It is a feeling of pain and pressure in the bladder area. Along with this pain are lower urinary tract symptoms which have lasted for more than 6 weeks, without having an infection or other clear causes.

Symptoms range from mild to severe. For some patients the symptoms may come and go, and for others they don't go away. IC/BPS is not an infection, but it may feel like a bladder infection. Women with IC/BPS may feel pain when having sex. The more severe cases of IC/BPS can affect your life and your loved ones. Some people with IC/BPS have other health issues such as irritable bowel syndrome, fibromyalgia, and other pain syndromes.

Symptoms

Pain

The symptoms of IC/BPS vary for each patient, but the most common sign is pain (often with pressure). Patients with IC/BPS may have bladder pain that gets worse as the bladder fills. Some patients feel pain in other areas in addition to the bladder, such as the urethra, lower abdomen, lower back, or the pelvic or perineal area (in women, behind the vagina and in men, behind the scrotum). Women may feel pain in the vulva or the vagina, and men may feel the pain in the scrotum, testicle, or penis. The pain may be constant or may come and go.

Frequency

IC/BPS sometimes starts with urinary frequency. Frequency is the need to pass urine more often than normal. The average person urinates no more than 7 times a day. He or she does not have to get up at night more than once to use the bathroom. A patient with IC/BPS often has to urinate frequently both day and night. As frequency becomes more severe, it leads to urgency.

Urgency

Urgency to urinate is a common IC/BPS symptom. Some patients feel an urge that never goes away, even right after voiding. A patient may not notice or see this as a problem. In other cases, the onset is much more dramatic, with severe symptoms occurring within days, weeks or months.