You leak a little or a lot, or you go so often it’s begun affecting your quality of life. You wonder if you suffer from the “overactive bladder” you’ve been hearing about so much about these days.
Just what is overactive bladder (nicknamed OAB), anyway?
First, while it can be embarrassing, even alarming, overactive bladder is not a disease. It is a condition, marked by an unexpected urge to urinate, sometimes accompanied by an involuntary loss of urine. Overactive bladder is common, affecting more women than men, becoming more common with age, during pregnancy, after a difficult labor or after multiple births.
However, some sources would have you believe that OAB is a dire matter.
Are You Getting Soaked?
A recent investigative report, Lowering the Bar: Just Exactly What Is Overactive Bladder? A cautionary tale about the way in which a simple question can lead to a new disease, jointly conducted by MedpageToday and the Milwaukee Journal Sentinel, details the history of the condition and how it gave rise to a highly profitable new industry.
- The authors report: “The very name ‘overactive bladder’ was created with marketing in mind.” (Its medical term is “detrusor instability.”)
- Last year, drug companies reported sales of nearly $3 billion from the 12 drugs that claim to “cure” OAB.
- Since 2013, the FDA has received reports of more than 12,000 serious side effects from OAB drugs, including delusions, kidney failure, and hundreds of deaths.
- Studies show that OAB drugs, which can cost hundreds of dollars per month, may perform no better than placebos.
- Furthermore, “The drugs . . . are not more effective than various treatments that involve exercises or other changes in behavior.”
Many conditions may cause frequent urination and/or bladder leakage, including undiagnosed urinary-tract infections and conditions that have little to do with the bladder, from organ prolapse and prostate disorders to neurological dysfunction. In these cases, treating the bladder symptoms may miss the root cause and will not cure it.
You’re in Control
If you’re troubled by unexpected bladder leakage, see your doctor to rule out underlying causes. Then consider asking about conservative, non-drug (and nonsurgical) therapies such as the following that may provide relief, avoid drug side effects, and save you a bundle. But remember, to be successful, these strategies all require your active, ongoing participation.
- Everyday life changes These include losing weight, increasing exercise, cutting back or quitting caffeine-containing drinks and alcohol, as well as modifying other aspects of diet and fluid intake.
- Bladder training This includes scheduling trips to the toilet, applying pressure to the perineum (e.g., straddling the arm of an armchair), to simple pelvic-floor exercises.
Pelvic-floor physical therapy (PFPT) A relatively new subspecialty within the field that requires extra training, pelvic-floor therapy involves an assessment of the muscles and other structures within the “pelvic bowl.” As with other areas of the body, any of the pelvic-floor muscles/tendons may be too tight, too weak, or out of balance, leading to bladder, bowel, and other pelvic-region problems. Your physician may not be knowledgeable about PFPT; consider asking for a referral to a therapist trained in this specialty.
For a detailed summary of the clinical diagnosis and treatment options, including behavioral changes and pelvic-floor physical therapy,For a detailed summary of the clinical diagnosis and treatment options, including behavioral changes and pelvic-floor physical therapy, visit Evaluation and management of overactive bladder: strategies for optimizing care.