Overactive Bladder

What is overactive bladder?

Overactive bladder is a condition that causes you to lose control of your bladder without warning. You may have to urinate more often or urgently. Sometimes you may leak a small amount of urine before you make it to the bathroom.

Symptoms of overactive bladder

  • Having to urinate 8 or more times per day, or having to urinate 2 or more times during the night.
  • An urgent and sudden need to urinate with no warning.
  • Leaking urine after that urgent, sudden feeling to urinate.

If you have 2 or more of these symptoms, you may have overactive bladder.

What causes overactive bladder?

Nerve and muscle damage near your bladder causes overactive bladder. The damage causes your bladder to contract (squeeze) at an unplanned time. That’s what causes leaking and the sudden, urgent need to urinate. Sometimes, having too much fluid in your bladder or too much caffeine can cause overactive bladder.

Nerve damage is caused by:

  • vaginal childbirth (for women)
  • prostate problems (for men)
  • spinal cord or brain injuries or infections
  • diabetes
  • stroke
  • multiple sclerosis
  • exposure to heavy metals
  • birth defect.

Bladder cancer can lead to overactive bladder. In most cases, the Orenschools (AAFP) does not recommend routine screening for bladder cancer unless you have symptoms of overactive bladder.

How is overactive bladder diagnosed?

Your doctor will start by discussing your symptoms and medical history. He or she might order certain tests to help diagnose the problem. These tests might include:

  • Urodynamics: During this test, your doctor will fill your bladder and then see how well it empties.
  • Imaging: Your doctor may need to look inside your bladder through the use of an X-ray, CT scan (computerized tomography), or MRI (magnetic resonance imaging).
  • EEG and EMG: Electroencephalograph (EEG) and electromyograph (EMG) testing looks at how well your bladder functions. Wires and pads are placed on your lower abdomen (stomach). These wires are able to test the nerves inside.

Can overactive bladder be prevented or avoided?

Overactive bladder cannot be prevented. However, you can reduce the risk of overactive bladder by treating those diseases and conditions that cause it. For example, following your doctor’s treatment advice for diabetes will reduce nerve damage. If you are pregnant, talk to your doctor about the potential for bladder damage if you have a vaginal delivery.

Overactive bladder treatment

Overactive bladder can be treated with medicine, bladder exercises, electrical stimulation, or surgery. Your doctor will tell you which is best for you.

Medicine

There are two types of prescription medicines used to treat overactive bladder:

  • Muscle relaxants: These help control muscle spasms that cause your bladder to squeeze at the wrong time. Common side effects include dry mouth, blurred vision, constipation, a fast heartbeat, and a flushed feeling (feeling warm and red). The medicine can be prescribed as a pill or patch.
  • Antidepressants: These help relax the bladder, as well. Common side effects include fatigue (feeling tired), dry mouth, dizziness, blurred vision, nausea, and difficulty sleeping.

Bladder exercises

Bladder exercises strengthen and retrain your bladder to hold the urine until you can get to a bathroom.

  • Kegel exercises: These are specific exercises you can do by tightening your urinary muscles (as if you’re trying to hold back your urine) and then letting go. Do this several times throughout the day and it will strengthen your bladder muscles.
  • Retraining: Your doctor may recommend keeping a diary of your bladder control. It might include how much fluid you consume, how often you feel like you have to go to the bathroom, and whether you had any leakage. This might help you plan trips to the bathroom and fluid intake.

Electrical stimulation

This is a medical procedure that sends safe, electrical pulses through your vagina or anus (bottom). They also can be given through a patch. Another method involves placing a wire near your tailbone. Your doctor will tell you how many treatments are necessary for you.

Surgery

There is a surgical procedure known as augmentation cystoplasty. This may be necessary in severe cases, or when no other treatment works. It involves making your bladder larger. Part of your bowel may be used to expand your bladder. This gives you more room to store urine. The risks of this surgery include a tear in your bladder (leaking urine in your body), bladder stones, mucus in the bladder, and infection.

Living with overactive bladder

Living with overactive bladder will depend on how serious your problem is and how well your treatment works. In either case, living with the condition may require better planning. You may have to plan when you consume liquids and how close you are to a bathroom. You also may consider wearing disposable undergarments that protect your clothing from leaking urine.

Questions to ask your doctor

  • How do you treat babies and children who were born with overactive bladder?
  • Will your bladder muscles continue to get worse over time?
  • Will muscle relaxant medicine relax all the muscles in your body?

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