An overactive bladder in women, the treatment of which is required immediately after detecting a problem, is a violation of the function of accumulation of urine and the emergence of a sharp desire to empty the bladder. Such a need is often acute and leads to the involuntary release of a certain amount of urine (incontinence).
Traditionally, therapy begins with the use of behavioral (behavioral) strategies - doctors recommend drinking water and other drinks strictly according to the schedule, visiting the toilet every day at a certain time and restrain sudden urges with the help of the pelvic floor muscles. If these measures do not help, there are other methods of treating pathology.
Symptoms
If you have problems with urination, it is not a fact that their cause is an overactive bladder. Symptoms in women are manifested as follows:
- the appearance of a sudden need to visit the toilet, and this need is extremely difficult to control;
- urinary incontinence, that is, its involuntary release immediately after the desire to empty the bladder;
- rapid urination, usually more than eight times a day;
- night polyuria (nocturia) - nightly urges to go to the toilet, repeated more than two times during sleep.
Although many patients manage to get to the toilet immediately, as soon as there is an urgent need, almost everyone suffering from this pathology experiences stress from having to empty the bladder many times a day.
Normal functioning of the organ
The kidneys produce urine, which then flows into the bladder. When visiting the restroom, urine exits the storage organ through an opening below and flows out through a tube called the urethra. In women, the urethral opening is located directly above the vagina, in men - on the tip of the glans penis.
As the bladder becomes full, signals from nerves enter the brain, which ultimately cause the need to empty. When urinating, nerve signals coordinate the relaxation of the muscles of the pelvic floor and urethra (the latter are called the muscles of the urinary sphincter). The muscles of the organ tighten (contract), pushing the urine out.
Causes of pathology
When the organ muscles begin to suddenly strain (even if the volume of urine in it is still small), doctors diagnose an overactive bladder. Symptoms in women include, first of all, a sharp appearance of need and may be accompanied by signs of diseases that serve as prerequisites for the development of this ailment. However, chronic diseases are not the only cause of the problem. Frequent toilet use and incontinence can be based on:
- neurological disorders, including Parkinson's disease, strokes, multiple (multiple) sclerosis;
- intensive urine production as a result of the consumption of large volumes of fluid, poor functioning of the kidneys or diabetes;
- taking medications that accelerate the production of urine or require drinking plenty of fluids;
- acute infectious diseases of the urethra, causing symptoms similar to signs of an ailment such as an overactive bladder in women;
- organ pathology (tumors, stones);
- factors that prevent normal urination (in men it may be an enlarged prostate, in women - constipation or past surgery in order to treat other forms of incontinence);
- excessive use of caffeine or alcohol;
- inhibition of cognitive function of the brain due to aging of the body, as a result of which the bladder can hardly recognize incoming signals;
- difficulty walking, due to which not all patients can get to the restroom in a timely manner;
- incomplete emptying of the bladder, which can lead to symptoms of hyperactivity due to reduced free space for new urine from the kidneys.
Often, however, even experts cannot say for sure what caused the development of the organ hyperactivity syndrome.
Diagnostics
If you suffer from an unbearable need to use the toilet too often, the doctor will first check your urine for blood or infection. You must also determine if you empty the bladder completely. A full diagnosis will most likely include the following activities:
- study of the history of diseases;
- primary medical examination with special attention to the organs of the abdominal cavity and groin;
- urine tests to check for infections, traces of blood and other signs of pathology;
- focused neurological examination to detect sensory impairment or reflex problems.
Special studies
First, the doctor will establish an accurate diagnosis and presumptive conditions for the development of such an unpleasant condition as an overactive bladder in women. Treatment will depend on many factors, but primarily on the quality of the functioning of the organ. The ability of the bladder to be regularly and completely emptied is checked by the method of urodynamic research, which consists of several different tests.
What is included in the concept of urodynamic analysis
- Measurement of residual urine volume. This analysis is especially important if the organ is not completely emptied during urination, or if you suffer from incontinence. Residual urine causes symptoms similar to those of hyperactivity. To measure the remaining fluid after emptying, the doctor will prescribe an ultrasound examination of the bladder or put in a special catheter (thin tube) to withdraw and examine the remainder.
- Urine flow rate measurement. If you need to evaluate the volume and speed of urination, the doctor will ask you to empty the bladder into an uroflowmeter, a device that measures these parameters and converts them into a graph of changes in the rate of emptying.
- Determination of intravesical pressure. The cystometry method helps to measure pressure in the organ and surrounding tissues when filled with liquid. During this study, the doctor uses a thin tube (catheter) to slowly fill the bladder with warm water. Another catheter with a sensor that is sensitive to pressure changes is placed in the vagina. This procedure helps to understand why there is an overactive bladder in women. Treatment will depend on what the analysis shows: either involuntary contractions of the walls of the organ or its stiffness, due to which the bladder becomes unable to store urine at low pressure, will be observed. You may be asked to empty during the study in order to measure the pressure necessary to empty the organ and to clarify the presence or absence of a possible blockage (obstruction). Obstruction due to prolapse of the pelvic organs can lead to symptoms typical of such a widespread malaise as an overactive bladder in women. Causes (treatment, as you know, can only be prescribed by a qualified specialist) in this case almost always include neurological diseases affecting the spinal cord.
Behavioral Therapy
Behavioral therapy, or the acquisition of useful habits necessary to combat an ailment, is the first and most effective measure on the path to recovery. The undoubted advantage of this method is the complete absence of side effects. If you have no idea how to treat an overactive bladder in women, try the following techniques.
Best practices for resolving issues
- Exercises for the muscles of the pelvic floor. It’s not without reason that Kegel’s exercises gained worldwide fame and unprecedented popularity: perhaps there is no more natural way to strengthen the muscles of the pelvic floor and urinary sphincter. Stronger muscles can permanently relieve you of involuntary contractions of the walls of the bladder. The doctor will give detailed advice on the correct implementation of the famous gymnastics. Follow the recommendations of a professional and be patient: for a noticeable improvement in well-being it often takes quite a long time (from six to eight weeks).
- Maintain a normal weight. If you are obese, returning to normal weight will help tame overactive bladder in women. Treatment (reviews can be found on thematic forums if you wish) in this case implies a diet based on the principles of proper nutrition.
- Control fluid intake. Your doctor may recommend limiting your fluid intake and help you create a convenient schedule for you to drink your favorite drinks.
- Double emptying. To the bladder is completely empty, you must wait a couple of minutes after the first emptying and then try again to cope with small needs.
- Scheduled urination. The scheduling method is useful not only in the sense of drinking liquids, but also for visiting the toilet. If you follow the planned schedule (for example, going to the restroom every 2-4 hours), the body will get used to the same regimen, and you will cease to experience unnecessary stress from suddenly rolling needs.
What else can be done?
- Intermittent catheterization. When an overactive bladder is diagnosed in women, treatment and reviews of the prescribed therapy largely depend on the individual effectiveness of the prescribed method. However, there is a general, universal way to alleviate the symptoms of pathology, which involves the periodic use of a catheter to completely empty the organ. Consult your doctor before using this method.
- Wearing urological pads. The use of urological pads or special absorbent underwear will help protect clothes from the effects of incontinence and eliminate the associated psychological stress. Such pads and underwear come in all sizes and have different absorption characteristics.
- Bladder training. This term refers to the development of one's own ability to contain a small need. You need to start with small periods - for example, from 30 minutes, after which you can gradually increase the intervals until you start going to the toilet only once every three to four hours. An overactive bladder in women (treatment, causes, symptoms discussed above) can be stabilized in this way only if you are able to strain (contract) the pelvic floor muscles on your own.
Overactive bladder in women: treatment (medication)
To reduce hyperactivity syndrome, medications are used that help relax the walls of the organ. It:
- tolterodine ("Detrol");
- oxybutynin in the form of a skin (transdermal) patch (Oxytrol);
- oxybutynin in gel form ;
- trospium;
- solifenacin;
- darifenacin;
- fesoterodine.
Be careful
The above medicines can cause side effects, including dry mouth and constipation, which can aggravate symptoms of an ailment such as an overactive bladder in women. Treatment (tablets and other drugs for oral administration) should be prescribed by a doctor, but if you suffer from these side effects, it is better to consult a specialist regarding the replacement of tablets with gels and patches.