Overactive bladder (OAB) is an abnormal bladder function that causes sudden need to rush to urinate. If overactivity is severe then incontinence may be associated that is bladder gets emptied or urine leakage occurs before reaching toilet. Many times increased urinary frequency is associated as bladder capacity is usually small in such cases. OAB mostly occurs in women though males are also affected.
Bladder outlet obstruction mainly urethral stenosis in women and prostatic obstruction in male are one of the most important causes of bladder becoming small and overactive. Small and stiff bladder can’t accommodate urine once capacity is reached & it tends to come out. Recurrent urinary tract infection in women for very long periods tends to cause small and overactive bladder. Diabetes may also be an added risk factor. Neurological conditions like multiple stenosis or spinal cord disease and injuries may cause overactive bladder. But in many patients we don’t find any cause at all.
Diagnosis of overactive bladder is usually reached through analyzing patient’s symptoms and performing tests like sonography, uroflowmetery and urodymamic studies.
Treatment of overactive bladder depends on the cause like urethral stenosis or prostatic obstruction. Relieving the obstruction often reverses the symptoms. But in many patients where no cause is found or in neurological conditions causing OAB treatment is difficult. Conservative therapy with fluid restriction, using diaper, staying close to the bathroom at night often makes patient’s life little easier. Anticholinergic drugs like dariten solifenacin, and mirabegron often helps to a great extent. But these drugs do have their side effects. When conservative and medical treatment fails or patients can’t tolerate medical therapy botox therapy comes into play.
Sometimes overactive bladder can be due to some disease of the bladder like tuberculosis or bladder carcinoma – in – situ & cystitis (inflammation of bladder) like eosinophils cystitis. In such condition diagnosis is usually done by doing cystoscopy & bladder biopsy. In cystoscopy a fine telescope fitted with camera is passed into the bladder though urine passage. Visual examination of bladder gives clear idea about these conditions. If necessary of small piece of bladder lining is taken & sent for histopathological diagnosis. Histopathology clearly diagnose if
anything like TB or ca-in-situ etc and accordingly treatment is carried out and patients may get relief. Sometime we instill BCG vaccine in bladder cancer patient to prevent cancer recurrence. Instillation of BCG may cause severe overactivity (though infrequent) & may necessitate stoppage of BCG therapy.
Institute of urology runs overactive bladder clinic (OAB clinic) where patients are evaluated in detail & necessary treatment is carried out. If you have any query regarding OAB you may please contact to the institute at “98290 – 13468” or instituteofurology.jaipur@gmail.com.
