facts for patient information on overactive bladder

1. Dr. BARUN KUMAR
MBBS,
MS (general surgery)
MCh urology
Male sexual health specialist
Contact:
barunkumar_urology@outlook.com
Teleconsult @ LYBRATE app
Code: BK5A76
Can also Book appointment
through practo or curefit app.

2. Overactive bladder

3. What is Overactive Bladder?
Overactive Bladder (OAB) isn't a disease
Name given to a group of troubling urinary
symptoms
Major symptom of OAB is a “gotta go”
feeling, sudden, strong urge to urinate that
patient can’t control

4. Anatomy of the Urinary Bladder
Female Urinary tract Male Urinary Tract

5. What are the Symptoms of Overactive Bladder ?
 Urgency is considered hallmark symptom of OAB. Urgency is
currently defined by the International Continence Society
(ICS),as "Sudden, compelling desire to pass urine that is
difficult to defer.
 Urinary frequency is considered abnormal if a person urinates
more than 8 times in a day.
 Nocturia is a symptom where the person complains of
interrupted sleep because of an urge to void (usually more
than 2 times a day).
 Urge incontinence is a form of urinary incontinence
characterized by the involuntary loss of urine occurring for no
apparent reason.

6. 1. Minassian VA, et al. Obstet Gynecol. 2008 Feb;111(2 Pt 1):324-31/ OAB symptom ref: Mayo clinic
Sudden urge
to urinate
that's difficult
to control
Involuntary
loss of urine
Urinate frequently, usually 8
or more times in 24 hrs
Awaken 2 or
more times in
night to urinate
(nocturia)
Significantly impacts QoL
Symptoms of urinary incontinence…

7. What are the causes of Overactive Bladder ?
 Normal Neurological Pathway :
Then urine is stored in the bladder.
When it isn’t full of urine, the bladder is relaxed. The nerve
signals in the brain send a signal to the bladder that it is
becoming full and the person feels the need to urinate.
 In Overactive Bladder:
The nerve signals between the bladder and brain are not in
sync and the brain send signals to the bladder to empty it even
when its not full.

8. How is Overactive Bladder Diagnosed ?
Overactive Bladder is diagnosed on the basis of history and duration of
symptoms .
 Investigations :
 Voiding Diary ( Time and Amount chart).
 Urodynamic Study.
 Urine Cultures, Ultrasound scan and other imaging studies like
Micturiting cystourethrograms to rule out any abnormal pathology of the
urinary tract .

9. What are the Treatments available for
Overactive Bladder?
 There are several treatments available to help manage OAB.
 Behavioral therapy: Lifestyle changes—known as “behavioral
techniques”—are often the first treatments used to manage OAB. In
behavioral therapy, you make some changes in the way you live day-
to-day.
 This may include changing your diet to see if less caffeine, alcohol,
and spicy foods will reduce your symptoms. Behavioral changes may
include going to the bathroom at scheduled times during the day,
and doing “quick flick” Kegel exercises to relax your bladder
muscle.

10. Bladder training
• Bladder training is a behavioral therapy that aims to
increase the time between urinating.
• Muscles control the bladder, which means that the
muscles can be strengthened a similar way to
working out your biceps and quadriceps.
• Bladder training can help to reduce urinary
incontinence by helping the bladder to hold more
urine and prevent it from being overactive.

11. • It can be useful to keep a diary of information
linked to your condition before you start
training so that you have a starting point from
which you can measure progress.
• In your bladder diary, record the times that
you urinate, whether or not you could
completely empty your bladder, the duration
between trips to the bathroom, and any other
relevant information.

12. • Schedule bathroom visits. The goal of bladder
training is to decrease the times that you
urinate each day to around six to eight times.
• Look at when you recorded going to the
bathroom in your bladder diary and gradually
extend the duration between bathroom visits.
For example, if you go to the bathroom once
per hour, aim to extend that to 1 hour and 15
minutes and increase that time gradually over
the few next weeks.

13. • Delay urination. If you feel the urge to go to
the bathroom, try to delay your trip by around
5 minutes. Slowly continue to delay urinating
until you can get to around 3–4 hours
between bathroom visits.
The following tips may help you to increase your
success with bladder training:
• Do not rush to the bathroom when you feel
the urge to urinate. Sit still and try to hold on
as long as possible.
• Avoid unhealthful habits of going to the

14. • Distract your attention by thinking about
something else.
• Try delaying tactics such as clenching your
fists or crossing your legs.
• Practice pelvic floor exercises to strengthen
your power to hold urine.
• Limit drinks that increase urination, such
as coffee, tea, and other caffeinated
beverages.

15. How to do pelvic floor exercises
• First, you need to locate your pelvic floor muscles,
which you can do by trying to stop your flow of urine
mid-stream. Exercises should be performed at first by
sitting on a chair with your feet flat on the floor, and
your elbows rested on your knees.
• Two types of exercises, called slow contraction and
fast contraction, should be performed to give your
pelvic floor a full workout. Always do the slow
contraction exercises first and then the fast
contraction exercises.

16. To practice slow contraction exercises:
• Draw up your muscles surrounding your anus as if
you are trying to stop yourself passing gas. However,
do not squeeze your buttock muscles.
• Also, draw up the muscles around your urethra as if
you are trying to stop urine flow.
• Hold this position for as long as you can. You may
only be able to hold this contraction for a couple of
seconds at first, but the goal is to hold for a count of
10 seconds.
• Slowly relax and let go for 10 seconds.
• Gradually increase the time you hold the
contraction and repeat until your muscles begin to
feel tired.

17. To practice fast contraction exercises:
• Draw up the muscles surrounding your anus and
urethra as before.
• Hold the contraction for 1 second and then let go and
relax.
• Repeat the contractions up to 10 times or until your
muscles tire.
• Try to come up with an exercise plan that includes 10 slow
contractions and three sets of 10 fast contractions twice per day.
• Make sure that you breathe normally while exercising and are
focusing on the correct muscles. You should begin to see results
within 3–6 months