Urinary Frequency/
Overactive Bladder (OAB)
Women with frequent urination and sudden unstoppable urges to urinate are considered to have overactive bladder or OAB. OAB can be a result of abnormalities of the nerves that supply the bladder or due to abnormalities of the muscle of the bladder itself. This results in sudden urges, urge incontinence, nighttime urination, and frequent urination.
In a normal functioning bladder, the nervous system sends signals between the brain and the bladder allowing the bladder to fill to capacity and the brain to know when it is time to urinate. When the brain receives the message to urinate, the detrusor muscle contracts forcing urine out of the bladder and the sphincter relaxes, allowing urination to occur. Dysfunction of the nerves involved in this process can result in poor bladder capacity and premature muscle contractions. Weak pelvic floor muscles and/or a weak urethral sphincter can contribute to urine loss in patients with OAB.
Proper treatment of overactive bladder requires evaluation to find the cause of symptoms.
Evaluation may include Urodynamics and Cystoscopy.
During urodynamics, a tiny catheter is used to fill your bladder slowly with warm water. Pressure in the urethra and bladder is measured continuously during urodynamics. The muscle strength of your pelvic floor is also measured continuously. As the bladder fills and empties, these measurements are used to identify the cause of your symptoms and aid in deciding what treatment is optimal.
During cystoscopy, the inside of the bladder and urethra are evaluated for abnormalities.
Treatment for OAB Includes:
Medications – this is generally the first line of treatment. Medications will not cure the problem but are used to control symptoms
Botox Injection. Botox is injected into the bladder to reduce bladder contractility. Currently, Botox use in urinary urge incontinence is limited to patients who have an underlying neurologic condition such as spinal cord injury or Multiple Sclerosis causing OAB.