Overactive Bladder in Men

Many men living with overactive bladder may feel as if they are alone. However, millions of people in the U.S. live with the life altering symptoms of OAB every day and some 30% of men have OAB symptoms that affect their quality of life. 

Rest assured that the incontinence specialists at Chesapeake Urology understand that urinary incontinence is a stressful and sometimes embarrassing problem for many men, and can provide comprehensive diagnosis and treatment. 

 

What is Overactive Bladder?

Overactive bladder, or OAB, is a group of symptoms rather than a specific disease. Yet, it is not a normal part of aging and can negatively affect a man's social, personal and work life in a number of ways. 

Think of OAB as that "gotta go" feeling, or extreme urge to urinate. This overwhelming urge is one of the main signs that you may be living with overactive bladder (OAB). Other symptoms of OAB include:

  • Urine leakage – the urge to urinate may cause your bladder to leak urine at inconvenient times

  • Increased frequency of urination – you may need to go to the bathroom many times throughout the day

  • Nocturia or waking up multiple times at night to urinate

    overactive bladder

Pictured: A normal bladder (left) and an overactive bladder with urine leakage (right).

 

Risk Factors for OAB

As men age, the prevalence of OAB certainly increases. Men with certain prostate conditions including prostate cancer, are at higher risk of developing urinary incontinence issues including OAB. Other risk factors include:

  • Neurological conditions that affect the brain or spine, including multiple sclerosis, Parkinson’s disease, stroke, cerebral palsy and spinal cord injury
  • Diabetes
  • Certain gastrointestinal conditions such as irritable bowel syndrome (IBS) 
  • Certain foods such as caffeine, alcohol and spicy foods can irritate the bladder and make OAB symptoms worse
  • Obesity and being overweight 

 

Diagnosing OAB

Your physician will perform a comprehensive medical history and evaluation to accurately diagnose your OAB symptoms. Your doctor will examine your abdomen as well as your prostate. Additional tests may also include:

  • Urinalysis
  • Blood work
  • A bladder diary – Your physician may ask you to keep a daily record of how often you make trips to the bathroom, what you drink, your urine output, and when any leakage occurs to gain a better understanding of your symptoms

Specialized tests may also be performed to get a clear idea of the cause of your OAB symptoms, including:

  • Pelvic ultrasound: This test checks for structural abnormalities of the lower urinary tract and can assess for bladder abnoralties.

  • Post void residual test (PVR): Determines how well you empty your bladder by measuring residual urine after voiding. Measuring residual urine may aid your doctor in determining if there is a blockage or nerve or muscle problem.

  • Cystoscopy: A small camera called a cystoscope is inserted into the urethra to inspect the urethra, prostate and bladder for any visual abnormalities. This procedure can be performed in your doctor’s office or ambulatory surgery center under topical local anesthesia.

  • Urinalysis and urine culture, which checks urine for the presence of infection or abnormalities. 

 

Treating OAB

Your doctor may recommend starting treatment with first line therapies such as physical therapy and lifestyle modification. These treatments typically do not cure OAB but can help minimize symptoms.

Physical Therapy: The goal of physical therapy for treating OAB symptoms is to decrease urinary urgency and improve the coordination between the bladder and pelvic floor muscles for improved urinary control. 

  • Bladder training or delayed voiding – This involves controlling the urge to urinate by waiting a few extra minutes after you feel the urge at first, and then gradually increasing the time between bathroom visits. 
  • Timed urination – You follow a set schedule for going to the bathroom. Instead of going when you feel the urge, you train yourself, and your bladder, to go at the scheduled time of day. Your physical therapist will determine if this is right for you.
  • Pelvic floor muscle exercises – These exercises strengthen the pelvic floor and sphincter muscles to help minimize urine leakage. 

Lifestyle Modifications 

  • Fluid and diet management – Limit or eliminate foods and drinks that may irritate the bladder such as caffeine, artificial sweeteners, chocolate, alcohol, certain sodas, citrus, and acidic and spicy foods.
  • Keep a bladder diary – Keep track of when and how often you go to the bathroom to urinate to help your doctor better understand your OAB symptoms.
  • Absorbent incontinence pads – Absorbent pads made specifically for urinary incontinence can protect your clothing and keep you dry, helping you avoid embarrassing incidents if you do experience incontinence during social situations or activities.

Medications

your urologist may prescribe anticholinergics or Beta-3 agonists, which work by relaxing the bladder to prevent bladder spasms. These medications can decrease the severe urge to urinate and may also enable the bladder to hold more urine without frequent leakage because the bladder is more relaxed.

As with most medications, it may take some time before you see an improvement in your urge symptoms and some side effects are possible. Continue with behavioral and lifestyle modifications as prescrbed by your doctor in combination with medication for best results. 

 

Neuromodulation Therapy

Neuromodulation therapy works by addressing the communication lapse between your brain and the nerves that control your bladder. If other treatments such as diet modification and medications have been unsuccessful in treating your OAB symptoms, neuromodulation therapy may be right for you.

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