Overactive bladder syndrome (OAB) is a condition that manifests itself in frequent, often uncontrolled urination. This disorder is commonly referred to as overactive bladder or overactive bladder. Find out what the symptoms of overactive bladder syndrome are and how they are being treated.
It is estimated thatoveractive bladder syndrome( OAB - overactive bladder ) affects 16 percent of adult Polish residents. An overactive bladder occurs in both women and men. In men, it can accompany disorders in urination with prostate enlargement and erectile dysfunction. Although statistically the number of women and men is similar, many more women are treated for overactive bladder (the incidence among women is around 8-42 percent and increases with age).
The causes of overactive bladder syndrome are mainly disturbances in the functioning of the nerves responsible for the functioning of the urinary system. And these disorders may result from damage to the nervous system, e.g. spinal cord, abnormalities related to neuromuscular connections, intercellular connections, and excessive sensory conduction. An overactive bladder may also appear in the course of diseases such as diabetes, Parkinson's disease, Alzheimer's disease, MS (multiple sclerosis).
Symptoms of overactive bladder syndrome
The appearance of an overactive bladder is indicated by:
- pollakiuria - repeated (more than 8 times a day) urination of small amounts of urine, caused by a painful feeling of urgency, as a result of pathological bladder contractions
- urgency - a sudden, overwhelming urge to urinate due to abnormal bladder contractions
- urge incontinence - involuntary, unstoppable leakage of urine caused by pressure of urgency
These symptoms may appear together or separately. Since many diseases can cause symptoms similar to those of an overactive bladder, other conditions should be ruled out in the first place. And they can be urinary and genital tract infections, kidney diseases, diabetes, as well as irritable bowel syndrome (this disease may be indicated by pressure, pollakiuria, pain in the lower abdomen, which disappear inAurine test , a plug-in test that measures the amount of leaked urine (for this, a urine-absorbing pad is put on overnight) to rule out possible other conditions. and after measurement). Moreover, ultrasound examination of the abdominal cavity is performed, as well as urodynamic examination performed in a hospital setting, but it does not require hospitalization. If you suspect a nervous system disorder, your doctor may order an MRI. Regardless of the tests, the patient is usually asked by the doctor to conduct the so-called a voiding diary, in which it records in detail the time, amount of urinated and all related ailments.
Treatment of an overactive bladder
There are three main methods of therapy: pharmacotherapy, electro-modulation, and surgery.
- Pharmacotherapy consists mainly in the administration of preparations that limit excessive bladder contractions. These are anticholinergic and spasmolytic drugs that relax smooth muscles. However, many of these preparations are burdened with side effects, therefore the search for new and more perfect ones is still ongoing. Prostaglandins, serotonin, dopamine and noradrenaline as well as nitric oxide, which is a neuromediator involved in the level of smooth muscles of the lower urinary tract, also play an important role in the regulation of the lower urinary tract function. If oral and intravesical medications do not help, neurotoxins such as vanilloids or botulinum toxin are used. When administered intravesically, they paralyze the nerve fibers of the bladder that cause excessive bladder contraction and pain.
- One of the methods of therapy is meuromodulation (electromodulation, electrostimulation), i.e. nerve stimulation with the use of various electrodes, external and implanted, stimulating the nerve fibers responsible for the functioning of the bladder and pelvic muscles.
- In treatment-resistant bladder hyperresponsiveness, surgical methods are also used to denerve the bladder. However, these are invasive treatments and therefore are the ultimate form of therapy.
- Behavioral therapies, which involve learning to control and modify reflexes related to urination and urination, are becoming more and more popular, both among doctors and patients. One approach is through typical bladder training, in which urination occurs at well-defined and lengthening intervals over time.
- Another type of behavioral therapy is biofeedback - bladder contraction and related changes in pressure are signaledby a sound the intensity of which increases with increasing pressure.
- Finally, if the bladder is overactive, pelvic floor muscle exercises can be successfully used.