The below questions on OAB were answered by Dr. Ross A. Rames, a urologist at the Medical University of South Carolina.

1. What exactly is OAB? 

   The hallmark of OAB is urgency. That is, when the need to urinate is noted, it is felt with a severity that makes it difficult to postpone. OAB may be accompanied by other symptoms as well, like getting up at night, leaking on the way to the bathroom, going frequently.

2. What are the symptoms of OAB? How are they different from other types of incontinence?

   The defining symptom is urgency, or the inability to postpone urination. Urge incontinence is similar, but involves the involuntary loss of urine associated with an urge. For more information on OAB causes and symptoms please click here.

3. Is OAB simply a part of aging? 

   While OAB is more common as we age, it should not be considered “normal”. It can have a terrible impact on quality of life and should be treated if it is bothersome.

4. What medical tests may be performed to diagnose OAB? 

   Urine analysis to look for blood, infection and sugar. Possibly a urine cancer screening test and a culture. Blood work may be indicated depending on urine findings and the patient’s history and exam. A bladder or voiding diary is very helpful.

5. Does OAB affect men as well as women? Is it more common in women? 

   The prevalence is the same in men and women. More than one-third of men and women over age 65 have OAB.

6. What causes OAB? 

   No one thing is the single cause. In some cases the bladder nerves may be responsible. In other cases, the bladder muscle itself may be the culprit. For more information on OAB causes and symptoms please click here.

7. Can Kegel exercises help with OAB? 

   Yes, in some cases. The key is doing them correctly and then continuing the Kegels. Many people need a “coach” to help them get it right and encourage them to stay with it. For information on performing Kegel exercises please click here. Men can click here.

8. How can a prostate problem contribute to OAB? 

   If the prostate obstructs the bladder outlet and creates elevated pressures during voiding, the bladder muscle reacts and undergoes changes. Part of these changes may make the bladder muscle more “irritable”, and result in more frequent and urgent voids. An enlarged prostate may also prevent the bladder from fully emptying, hence contributing to frequent signals to urinate.

9. Does menopause have a role in contributing to OAB? 

   The vagina and urethra have estrogen receptors. When estrogen levels are low, these tissues may thin and become irritated. That irritation may aggravate OAB symptoms. Local estrogen administered vaginally can make a difference for some women.

10. Can an illness or bladder infection cause OAB? 

    Bladder infections usually do not cause OAB. Once the infection clears, the symptoms usually get better. Having said that, some patients report that their OAB followed a triggering event, like a bladder infection.

11. Could my weight or diet be contributing to my OAB? 

    Obesity can cause bladder problems like OAB and leakage. Think of it like being pregnant and having all the extra weight bearing down on top of the bladder. Some food and drink can be irritating to the bladder in some people. Acidic foods are usually the most offensive, but often our patients learn which are bothersome to them by trial and error.

12. Can prescription or over-the-counter medications contribute to my OAB? 

    Yes, they can make OAB worse. Especially the diuretics and caffeine containing compounds.

13. What is bladder retraining? Will it help me control my OAB? 

    Progressively prolonging time between voids on a structured schedule to enlarge the bladder’s functional capacity may help alleviate some OAB symptoms, especially frequent urination. It is worth a try, but does not work for everybody. For more information on Bladder Retraining click here.

14. Can a condition like Multiple Sclerosis (MS) or Diabetes contribute to OAB and will the urgency / frequency stop with treatment? 

    Both MS and diabetes can damage nerves, and that nerve damage can result in symptoms in the urinary tract. Additionally, poorly controlled diabetes can result in the loss of sugar in the urine, and that can cause people to produce a greater volume of urine than normal (polyuria). The extra volume may aggravate or mimic OAB.

15. What medications are available for OAB? 

    The first line medications are the anticholinergics. These are the medications that block nerves connected to the bladder. Some of these are Detrol®, Ditropan®, Oxytrol®, Enablex®, Vesicare®, and Sanctura®. Other medications may be used, like tricyclic antidepressants: Imipramine, Elavil®, etc. For a complete list of the available OAB medications on the market, please click here.

16. Can childbirth cause OAB? 

    Trauma from childbirth can definitely cause bladder symptoms ranging from OAB to stress urinary incontinence.

17. I experience chronic constipation. What impact could this have on my OAB? Could the constipation contribute to my OAB? 

    Your colon and bladder are next-door neighbors. If your colon is full, it can actually compress your bladder and cause bladder problems.

18. If I restrict my fluid intake, will it help my OAB symptoms?

    We do not recommend that people dehydrate themselves. Having said that, reducing or eliminating caffeine, and moderating fluid intake to bring total urine production over 24 hours to 1500-2000cc is a sensible first step in addressing OAB, and often helps. For more information about fluid management, please click here.

19. My doctor diagnosed me with OAB and since then I’ve tried a variety of drug therapies, but they always make my mouth unbearably dry. Why is this and what else can you suggest? 

    Most of the medications we use for OAB are called anticholinergic drugs, and this class of medications blocks the nerves that are responsible for saliva production to a varying degree. Some people have little or no trouble, others have severe dry mouth. Because there are now more than eight different formulations – and at different dosage levels – I would suggest trying the various prescription drugs available, and in addition, try sugar-free hard candy, gum, etc. Your pharmacy also has a line of oral care products specially formulated for dry mouth. Most standard toothpastes and mouthwashes can be drying.

20. I have an enlarged (non-cancerous) prostate. My urologist indicated that this was the main cause of my overactive bladder experiences. He suggested an operation to diminish the size of the prostate. Do you think that this is the best way to regain total control of my bladder? 

    If your bladder outlet is obstructed for this reason, relief of that blockage will likely help alleviate the symptoms.

21. I have noticed that many of the medications prescribed for OAB indicate tachycardia or rapid heart beat as a possible side effect. Why is this the case? Is there a medication for this condition that does not have tachycardia as a possible side effect? 

    Most of these medications are called anticholinergics and work by blocking certain nerves associated with the bladder. Unfortunately, they block other nerves in other organs and that is why we have side effects.

22. What can be done for the patient who leaks only with a change in position, such as when getting out of bed? 

    It depends on the cause. The leak could be from stress urinary incontinence or an overactive bladder muscle. Having said that, it seldom hurts to try an OAB medication while you and your doctor sort this out.

23. Is overactive bladder caused by Parkinson ‘s disease? Or made worse? 

    Parkinson’s disease hurts parts of the brain that help to control the bladder. If it is serious enough, the bladder may malfunction and start to give symptoms of urgency and incontinence.