Do you find yourself running to the bathroom all the time, or having this strong urge to
run to the bathroom but you can't make it and sometimes having accidents, or are you waking
up all night to go to the bathroom well you might have overactive bladder. I'm Dr. Rena
Malek urologist and pelvic surgeon and today we're going to talk all about overactive bladder
if you're new here I make content every week about sexual health bladder health urologic health and
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so what are the symptoms of overactive bladder well there's four major symptoms one is
frequency or having to go to the bathroom more often than usual and the definition that we use
is more than eight times a day is considered abnormal of course if you're drinking a lot
more water you're gonna go to the bathroom a lot more but if it's affecting your quality of life
then that's something that is concerning another thing is urgency which is essentially the sudden
desire or urge to run to the bathroom that you cannot hold off you can't delay at all sometimes
this can be associated with bladder leakage or having an accident this is called urgency urinary
incontinence and lastly waking up at night to urinate more than one time is considered abnormal
and this is called nocturia so those are all the symptoms that taken together make up overactive
bladder and the most important thing about these symptoms is how they affect your quality of life
overactive bladder essentially is a problem that affects quality of life but it's not that simple
it can affect more than just how bothered you are it can affect how productive you are at
work if you're always running to the bathroom you certainly can't get work done it can affect your
social relationships and cause isolation because you don't feel like you can go to the bathroom
sometimes people have to even map out where the bathrooms are wherever they go because they're
afraid of having an accident or they can't go to the movies or go on long trips because they really
have to go to the bathroom so frequently that it makes it impossible and financially this can
be very problematic you can end up spending lots and lots of money on absorbent pads and diapers
and underwear and bedding and all that can really add up so taken together this can be a really big
problem and when they've looked at studies about how many people have overactive bladder they
found that about 16 of the population has these symptoms that's not a small number of people also
it can affect your relationships in the bedroom so if you're having accidents during sex it's
going to potentially inhibit your desire to have sex so what causes overactive bladder well age
is a common cause many times people will develop symptoms of overactive bladder related to age that
doesn't mean it's normal to have these symptoms it just means that that is a cause of these symptoms
also being overweight can contribute to urinary incontinence or leakage in fact when they look at
women who are obese they have a threefold times more likelihood of having urinary incontinence
episodes compared to women who are not obese also having a history of vaginal deliveries or multiple
pregnancies can contribute as well other medical problems can also cause overactive bladder the
most common ones are things like diabetes depression having a history of a surgery
either a hysterectomy or radiation to the area and other neurologic conditions like having multiple
sclerosis parkinson's disease spinal cord injuries or stroke all can contribute to symptoms of
overactive bladder also if you've had surgery like a mid urethral sling or a public vaginal sling for
stress urinary incontinence those are surgeries for leakage that occur with coughing sneezing
lifting exercise those surgeries can also cause what we call obstruction or blockage of the p-tube
which can lead to worsening overactive bladder symptoms other things to consider are maybe if
you're having recurrent urinary tract infections that can cause symptoms of overactive bladder as
well as certain medications like water pills very often if you're taking diuretics or water
pills for high blood pressure or swelling that can make your overactive bladder symptoms much worse
when you come to see a urologist for your symptoms of overactive bladder first we're going to ask you
several questions about your symptoms when do they happen how many pads a day are you using what's
bothering you the most about it how often are you going to the bathroom during the day and at night
also what's your history do you have any medical problems or surgeries in the past that might be
contributing to this then we'll do a physical examination and during that exam we'll look for
any abnormalities that might be contributing to symptoms of overactive bladder like cysts
underneath the urethra or around the urethra or p tube and men will do a prostate exam to see
if there's any enlarged prostate which can very often cause symptoms of overactive bladder if you
want to learn more about a prostate exam make sure you see my last video about doing prostate exams
on men where i react to the try guys also we'll check your urine to make sure there's no blood or
urinary tract infections because that could signal other problems we'll also do a bladder scan or a
post void residual and what that is is a little ultrasound that we do on the bladder to see how
well you're emptying your bladder are you emptying well or is your leakage happening because you have
a lot of urine left over after you urinate and you're not completely emptying so i have a really
special surprise for you guys i have a over active bladder guide which i've created for you guys
completely free make sure you look at the link in the description down below and it'll help you
figure out exactly what symptoms you have how to manage those symptoms and if you're having
to care for someone with overactive bladder how to do that so make sure you check it out download
it completely for free in the description below so what are treatments for overactive bladder
as i mentioned earlier being overweight can contribute to symptoms of overactive bladder
and studies have shown that losing as little as eight percent of your body weight so if you're
200 pounds that's about 16 pounds of weight that you can actually significantly improve
your urinary symptoms so that's a great place to start another thing to do is to avoid bladder
irritants i made an entire video about bladder irritants which you can check out but the simple
things that you can avoid are alcohol caffeine for some people spicy foods acidic foods artificial
sweeteners and carbonated beverages but what i tell people is don't dramatically change your life
eliminate one thing see how it goes for a few days if it doesn't make a difference you can
put it back in and try to eliminate something else don't drive yourself crazy over this other
things you can do are make sure you're drinking enough but not too much so you don't want to over
drink because that means you're going to go to the bathroom more often and if you
under drink actually that can create your urine to be more concentrated which can then irritate the
bladder lining what i tell my patients is drink whatever you want with breakfast lunch and dinner
and then sip on a bottle of water throughout the day but don't take big gulps and try to make some
major amount of fluid in fact if you do that and you're eating fruits and vegetables and smoothies
and soups you're going to have plenty of fluid you're not going to be dehydrated of course if
you feel thirsty you should always drink another big thing is avoiding constipation constipation
is a big problem and the reason for that is because the rectum sits right behind the bladder
so when it gets full because you haven't had a bowel movement it actually pushes on the bladder
making it have less room to expand so that you have more urgency and frequency and worse symptoms
lastly if you smoke you want to quit smoking smoking not only worsens symptoms of overactive
bladder but also a risk factor for bladder cancer so it's really important to quit smoking you can
also see a pelvic floor physical therapist and they can help you do exercises that can help
retrain your bladder so what i tell people is when you get the urge to urinate it's like a bell curve
and when you hit that urge really strongly you typically run to the bathroom before the urge goes
away but if you wait and you distract yourself with quick kegel exercises you'll notice that
the urge will slowly go away and after it goes away you can calmly walk to the bathroom of course
before you start any kegel exercises make sure you see a urologist to get an exam to make sure you
don't have other issues like a high toned pelvic floor that might be causing problems as well
if these don't work then there are medications that are available to you that can help reduce
either the contractions or squeeze of the bladder or can help the bladder relax you can check out my
video with a little more detail about overactive bladder medications i did previously to learn more
about them and if those don't work there are still other treatments available there are things like
a bladder pacemaker which i made a video about previously there's also a bladder botox where we
do injections in the bladder wall with botox that lasts about six to nine months so it is a repeated
procedure that's done every six to nine months but both that and the bladder pacemaker about 80
effective in reducing symptoms of overactive bladder lastly there's percutaneous tibial nerve
stimulation and that's kind of like acupuncture where we put a little needle in the ankle
that stimulates the posterior tibial nerve and that nerve goes all the way up to the roots
that then stimulate the bladder and so actually stimulating that nerve for 30 minutes once a week
for 12 weeks and then once a month after that can actually help people improve their symptoms
about 60 to 70 percent there's also a new device on the market that's an implantable device that
can go in the ankle that will then automatically stimulate you at home so you don't have to come
to the office so frequently and that's also in early studies very promising showing up to 70
improvement in overactive bladder symptoms after a quick straightforward procedure in the office
so i want you to rest assured that we have lots of tools in our toolbox to help improve
your overactive bladder so if you're suffering please see a urologist and we can help improve
your overactive bladder as always you want to take care of yourself because you're worth it