Doctors say that weak pelvic muscles, nerve damage, some specific medications, alcohol, caffeine, urinary tract infections, excess weight, and estrogen deficiency after menopause, are the main causes of overactive bladder. Dr Iba Mayele, an obstetrician gynaecologist at Clinic Galien, Kimironko, says that overactive bladder causes a sudden urge to urinate, the urge may be difficult to stop and overactive and may lead to reflex loss of urine. According to Dr Mohamed Okasha, an obstetrician gynaecologist at Legacy Clinics, Kigali, overactive bladder is a condition in which the bladder presses urine out, at the wrong time. SYMPTOMS Okasha notes that one may have an overactive bladder if they have two or more of these symptoms, for instance; if urge to urinate is eight or more times a day, or more times at night, or one experiences sudden, strong need to urinate immediately and leaks urine after a sudden, strong urge to urinate. Mayele notes that an abrupt urge to urinate that’s difficult to control, the involuntary loss of urine immediately following an urgent need to urinate, and awaken two or more times in the night to urinate, are all signs of over active bladder. He stresses that over active bladder occurs because the muscles of the bladder start to contract involuntary even when the volume of urine in the bladder is low. The involuntary contractions create the urgent need to urinate. Mayele says several conditions may contribute to signs and symptoms of overactive bladder; that is to say; neurological disorder such as stroke and multiple sclerosis. Diabetes medication can also cause a rapid increase in urine production. “Acute urinary tract infection abnormalities in the bladder, such as tumour or bladder stones, or factors that obstruct bladder outflow, enlarged prostate and constipation, can also lead to overactive bladder,” he notes. Mayele says several conditions may contribute to signs and symptoms of overactive bladder. Neurological disorders, such as stroke and multiple sclerosis, medications that cause a rapid increase in urine production or require you to take lots of fluids, and acute urinary tract infections can cause symptoms similar to an overactive bladder. He adds that others factors that can lead to overactive bladder could be excessive consumption of caffeine or alcohol, waning cognitive function due to ageing, (which may make it more difficult for the bladder to understand the signals it receives from the brain), and incomplete bladder emptying, since one may have little urine storage space left. RISK FACTORS As you age, he explains, you are at increased risk of developing overactive bladder but you are also at a higher risk of disease and disorder, such as enlarged prostate and diabetes which can contribute to other problems with bladder functioning. DIAGNOSIS Okasha says that if you have an abnormal urge to urinate, your doctor will check to make sure that you don’t have an infection or blood in your urine. The doctor can also look out for medical history, physical exam—focusing on the abdomen and genitals, urine sample to test for infection, sample of blood and other abnormalities. He says, focused neurological exam can also be done to identify sensory problems or abnormal reflexes. You can do special tests, like measuring urine left in the bladder, evaluate urine flow rate, test bladder pressures where the doctor will review the results of any tests and suggest the treatment strategy. PREVENTION/TREATMENT Mayele says a combination of treatment strategies may be the best approach to relieve overactive bladder symptom behaviour; intervention is the first choice, pelvic floor muscle exercise, healthy weight schedule, toilet trips, schedules for toileting, for example, every two to four hours to urinate at the same time every day rather than waiting until you feel the urge to urinate. COMPLICATIONS Okasha explains that any type of incontinence can affect overall quality of life. If overactive bladder symptoms cause a major interruption to one’s life, they might also have emotional distress or depression, anxiety, sleep disturbances, interrupted sleep cycles and issues with sexuality. editor@newtimesrwanda.com
