Overactive Bladder
Medical Author: William
C. Shiel Jr., MD, FACP, FACR
Medical Editor: Dennis Lee, MD
What is an overactive
bladder?
An overactive bladder is a condition that results
from sudden, involuntary contraction of the muscle in the wall of the urinary
bladder. Overactive bladder causes a sudden and unstoppable need to urinate
(urinary urgency). Overactive bladder is also referred to as urge incontinence
and is a form of urinary incontinence (unintentional loss of urine).
Overactive bladder is especially common in older
adults. Overactive bladder affects an estimated one in 11 adults in the United
States. Overactive bladder, however, should not be considered a normal part of
aging.
What are symptoms of
an overactive bladder?
The symptoms of an overactive bladder include
frequent urination, urgency of urination, and urge incontinence. Overactive
bladder may cause significant social, psychological, occupational, domestic,
physical, and sexual problems. Again, these symptoms should not be considered a
normal part of aging.
What are treatments for an
overactive bladder?
The treatment for overactive bladder depends on
the capabilities of the patient. Here are commonly recommended treatments:
Pelvic muscle rehabilitation to improve pelvic muscle tone and prevent
leakage
- Kegel exercises: Regular,
daily exercising of pelvic muscles can improve, and even prevent, urinary
incontinence. This is particularly helpful for younger women. These exercises
should be
performed 30-80 times daily for at least eight weeks.
- Biofeedback: Used in
conjunction with Kegel exercises, biofeedback helps people gain awareness and
control of their pelvic muscles.
- Vaginal weight training:
Small weights are held within the vagina by tightening the vaginal muscles.
These exercises should be performed for 15 minutes, twice daily, for four to
six weeks.
- Pelvic-floor electrical stimulation:
Mild electrical pulses stimulate muscle contractions. This should be done in
conjunction with Kegel exercises.
Behavioral therapies to help people regain control of their bladder
- Bladder training teaches people to resist the urge to
void and gradually expand the intervals between voiding.
- Toileting assistance uses routine or scheduled
toileting, habit-training schedules, and prompted voiding to empty the
bladder regularly to prevent leaking.
Medications for overactive bladder to improve incontinence medically
- Oxybutynin (Ditropan) prevents urge incontinence by relaxing sphincter muscles.
- Tolterodine (Detrol, Detrol LA) is indicated for the treatment of an overactive bladder
with symptoms of urinary frequency, urgency, or urge incontinence.
- Estrogen, either oral or vaginal, may
be helpful in conjunction with other treatments for postmenopausal women
with urinary incontinence.
Next: What are treatments for the
chronically incontinent? »
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