The act of urination is controlled by nerve impulses triggered by a full urinary bladder (temporary storage unit of urine). The nerves signal the muscles (urinary sphincter muscles) around the bladder to relax and contract, pushing urine to the outside. Overactive bladder is a condition where you find it difficult to hold back urine, and you have a sudden urge to urinate, urinate frequently, urinate two or more times in the night (nocturia) and experience leakage of urine (incontinence). Overactive bladder can lead to a lot of emotional distress and embarrassment, especially when it occurs during social interactions and work schedules.
This embarrassing problem is caused by the involuntary contraction of the sphincter muscles. Other conditions, such as stroke, diabetes, acute urinary tract infections, bladder stones, enlarged prostate gland and constipation, can also cause overactive bladder.
When you visit your doctor with complaints of uncontrolled urges to urinate and incontinence, special tests are performed to measure if your bladder empties completely, assess the pressure around it, and the speed and volume of your voiding.
To treat an overactive bladder, your doctor will first suggest behavioral intervention, which includes Kegel exercises to strengthen the muscles, maintaining a healthy weight, controlling fluid intake, scheduling voiding, using a catheter (thin tube) to empty the bladder, wearing absorbent pads and bladder training. Medication, direct injection of Botox or stimulation of nerves that signal the bladder may be suggested. If you do not respond to these conservative treatments, your surgeon may increase the capacity of the bladder or remove the bladder entirely, creating an opening called a urostomy, which is connected to a bag that collects urine.