What should you do if you have an overactive bladder?

Overactive bladder, also known as OAB, is a condition where sudden involuntary contractions of the urinary bladder's muscular walls cause bladder storage dysfunction. It leads to sudden and frequent urges to urinate (urinary urgency), as well as unintentional leakage or urine (urinary incontinence).

This is a condition that affects both men and women and causes tremendous discomfort in nearly every aspect of daily life. The specific causes of OAB vary from case to case but it is generally attributed to infection of the urinary tract or dysfunction of the nervous system. The symptoms are intensified by unhealthy lifestyle choices such as overindulging in caffeinated drinks, spicy foods, and alcohol.

There are several ways in which you can deal with the problem of OAB, depending on the nature of the case. It is necessary for you to consult a urologist for a detailed diagnosis to formulate the best treatment option.

Following are the most effective remedies to treat an overactive bladder:

1. Lifestyle Modifications

Also known as behavioral therapy, this is the first step in the treatment of OAB. It involves inculcating simple changes into everyday habits such as avoiding food and drinks that irritate the bladder, scheduling (and in some cases, practice delaying) bathroom visits, exercising the pelvic floor and bladder muscles, keeping a record of urinating habits in a 'bladder diary' for better understanding the problem, etc. You can incorporate these habits into everyday activities for an easy alleviation of the problem with absolutely no side effects.

2. Medication and Surgery

There are several different kinds of medicines and drugs that can treat the problem of OAB. The most common types are muscle relaxants that loosen the muscles of the urinary bladder to prevent involuntary contractions, and antibiotics and anti-inflammatory drugs that treat urinary tract infections. Many types of implants are surgically set into the pelvic area to act as electrical nerve stimulators for neuromodulation therapy. Reconstructive bladder surgery is another remedial option.

3. Devices and Products

Urinary urgency and incontinence can be managed through the external use of various devices and products which collect and hold urine or absorb leakages. These include indwelling catheters, condom catheters (for men), urine drainage bags, absorbent pads and adult diapers, and toilet substitutes such as bedpans and bedside urinals.



What Should You Do if You Have an Overactive Bladder?

An overactive bladder is marked by problems with one s bladder storage system that results in sudden urge to urinate. Involuntary and leakage of urine is also a possibility in such a case.

The problem of an overactive bladder arises when the muscles of the bladder contract involuntarily. The conditions contributing to overactive bladder are:
1. Excessive production of urine due to diabetes, poor kidney function or excessive fluid intake
2. Medications that increase urine production by the bladder
3. Acute infections in the urinary tract
4. Abnormalities in the bladder, for instance, bladder stones or tumors
5. Factors hindering bladder outflow such as constipation, enlarged prostate or earlier treatments for incontinence (loss of bladder control)
6. Excessive intake of alcohol or caffeine
7. Decline in one s cognitive abilities due to factors such as ageing, thus making it hard for the bladder to comprehend the signals it gets from the brain
8. Incomplete emptying of the bladder, leaving only a little storage space for the urine
9. Constipation
10. Neurological disorders

How it can be treated?

Behavioral interventions help to manage overactive bladder effectively and without side-effects. They include-
Exercises to strengthen one s urinary sphincter and pelvic floor muscles
Maintaining a healthy weight
Regulating fluid consumption
Planning a schedule for trips to the toilet
Employing a catheter to empty the bladder entirely
Medications to alleviate the symptoms of incontinence and overactive bladder are-
Fesoterodine
Mirabegron
Darifenacin
Solifenacin
Trospium
Oxybutynin gel
Oxybutynin as a skin patch
Tolterodine
Injecting small doses of Botox (Botulinum toxin), protein-bacteria, directly into the bladder tissues to partially paralyze the bladder muscles, thus delaying urination.
Surgery to magnify bladder capacity
However, it is a must that you seek the guidance of a urologist on immediate basis. 

Overactive Bladder - Can Infection in Urinary Tract Lead To it?

The bladder is a hollow storage organ that collects urine from the kidneys and stores it until it can be passed out of the body through the urethra during the process of micturition or urination. It has a thin inner lining of cells called urothelial cells and a thick muscular wall, which exerts pressure to push the urine out of the body.

Causes of Bladder Tumors

In most cases, the bladder tumor develops on the inner layer due to a combination of some of the following factors.

1. Hereditary: A strong family history of cancer predisposes a person to cancer.
2. Gender: Men are 3 times more prone for bladder cancer than women.
3. Ethnicity: White people are more prone for bladder cancer black people.
4. Smoking: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. cigarettes contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to their damage.
5. Occupational hazards: Some workplaces have a higher likelihood of causing bladder cancers, especially dye and rubber industries. The effects can be damaging, and the person may develop cancers years after the exposure has happened.
6. Recurrent bladder infections: In some people, this can also lead to bladder cancer in the long run.

Types of Bladder Tumor

Depending on the extent of the cancerous spread, it can be of two types:

1. Non-muscle-invasive bladder tumors: The tumor spread is limited to the inner part of the bladder (urothelial cells)
2. Muscle-invasive bladder tumor: The tumor has spread to the thick muscular outer layer. This is more advanced and prognosis is poor compared to the noninvasive type.

The most common and diagnostic symptom of bladder cancer is the presence of blood in the urine, known as hematuria. This will be intermittent and happens whenever the tumor bleeding happens. Other symptoms include pain in the lower abdomen and frequent urination.

Diagnosis

From the most noninvasive to the most invasive diagnostic test, these include:

1. Urine microscopy to detect cancer cells in the urine
2. Cystoscopy A tube inserted into the urethra to look into the inner wall of the bladder is highly diagnostic
3. Ultrasound, CT Scan, and biopsy can also be further used to identify severity of the tumor.

Treatment

Once the tumor is diagnosed, treatment would depend on the severity of the tumor. For both invasive and noninvasive tumors, definitive therapy is surgery, known as transurethral resection of the bladder tumor (TURBT). The cancerous bladder tissue is removed through a cystoscope as done for diagnosis. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder. This is then followed by BCG vaccine, which is again done 1 to 4 weeks for several months to avoid recurrence. In some cases, radiotherapy may also be included.

Bladder Tumor and Its Common Causes

Bladder cancer is characterized by irregular growth of abnormal tissue (tumor) on the lining of the bladder. This type of cancer may spread to the surrounding tissues or other body parts as well.

What are the causes?

Bladder cancer can be caused by environment-related factors and smoking. In fact, smoking tobacco is one of the major causes of bladder cancer around the world. The chemicals present in tobacco can irritate the bladder lining which ultimately leads to bladder cancer. It may also be caused by continuous exposure to chemicals such as dyes or leather dust and radiation. These chemicals tend to cause unusual changes in the cells of the bladder lining and causes cancer in the bladder.

It can also be caused by modifications in the dna in the cells of the bladder which may impair the functioning of the cells in the body. This can cause mutations in the bladder resulting in cancer.

What are the symptoms?

1. Presence of blood in the urine, often painless

2. Feeling of pain while passing urine

3. Back pain

4. Excessive urination

5. Infections in the urinary tract

6. Lower leg swelling

7. Pain in the bones, especially in the pelvic area

8. Weight loss

Treatment options

Treatments for bladder cancer depend on the stage of the cancer. The various treatment choices are:

Surgery - In some cases, these cancers are surgically removed by a surgeon. A type of surgery used is transurethral resection of bladder tumor (turbt) where the cancer cells are destroyed with laser by passing a thin fiber into the bladder.

Chemotherapy - In this method, medications are used to target and destroy cancer cells.

Radiation therapy - Radiation therapy uses rays such as x-ray or uv rays to destroy cancer cells in the body

Immunotherapy - This treatment boosts the immune system of the body so that it attacks the cancerous cells in the bladder.

Causes And Symptoms of Bladder Cancer

There are many types of cancer that may affect the human body. Bladder cancer is one such cancer that is caused when there is an abnormal growth and accumulation of the cells in the bladder. This kind of growth may cause mutations which can then manifest into tumours that may or may not be malignant. 

Let us find out more about the causes and risk factors of bladder cancer.

Transitional cell carcinoma: In this kind of bladder cancer, the transitional cells that line the inner region of the uterus and urethra will expand when the bladder is full. Further, these cells will end up contracting when the bladder is empty. This will lead to numerous complications which can cause the formation of tumours as an end result.
Squamous cell carcinoma: The squamous cells are those that are usually found in the bladder as a response to any kind of infection or even irritation in the area. These cells become cancerous over a certain period of time. This is also one of the most common types of bladder cancer in the US, as per various medical reports.
Adenocarcinoma: This kind of cancer usually starts in the cells that make mucus and form glands for the production of the same, in the bladder. This is a rather rare form of bladder cancer.
Risk factors: There are a number of risk factors that may affect the manifestation of the abnormal cell growth which can lead to any one of the above types of bladder cancer. Let us learn more about these risk factors.
Smoking: Smoking does not merely cause lung cancer, but it is also capable of causing chemicals from tobacco to accumulate in your urine and lead to several complications, including the increase of abnormal cell growth in the bladder. These chemicals may also cause widespread damage to the lining of your bladder.
Diabetes medication: One of the side effects of taking certain types of diabetes medication may be seen in the bladder and its cells. Pioglitazone is one such medicine which can cause these kinds of complications.
Chronic bladder inflammation: Repeated bladder infections may cause an unhealthy amount of persistent inflammation, which can lead to the growth of cells in an abnormal manner. This can lead to damage of the bladder s inner lining. In such a case, bladder cancer becomes a risk for the patient.
Family history: A family history of the condition also leaves the person susceptible to this disease. Colorectal cancer instances or Lynch syndrome cases in the family can increase the risk of contracting bladder cancer. This is due to the fact that the faulty gene can affect the various organs of the urinary area.

Bladder Cancer - Risk Factors Associated With it!

Hunner's ulcers, simply put are painful ulcers in your urinary bladder. These ulcers are inextricably linked to another disorder called the painful bladder syndrome or intestinal cystitis. They occur in 10 to 15 percent of people with interstitia cystitis. These, in fact, are red patches or lesions on the bladder wall which can stiffen tissue and cause reduced bladder capacity. Hunner s ulcers bleed, ooze pus and can be of different sizes. The ulcers in the bladder can be extremely painful and uncomfortable.

These are called Hunner s ulcers because they were first described by Dr. Guy LeRoy Hunner, a Johns Hopkins gynecologist, in 1915. Since Hunner s ulcers are seen only in people with intestinal cystitis, it s important to know more about this painful life-altering bladder disorder before we can even understand how to deal with them.

Interstitial cystitis (IC)
IC is also called painful bladder syndrome. Another important thing to know about IC is that it strikes more women than men. IC is a chronic disorder and there s no cure for it. It causes recurring bouts of pain and pressure in the urinary bladder and the pelvic area. This is often accompanied by an urgent and frequent need to urinate. Sufferers may have to rush to the  loo  as much as 40, 50, or 60 times a day.

Diagnosis
Hunner's ulcers can only be accurately diagnosed by doing a cytoscopy which involves inserting a fibre-optic tube through the urethra to look at the bladder wall closely. During this procedure, a tissue sample from the bladder wall is usually also taken to rule out bladder cancer. Cytoscopy is usually done with hydrodistention under local anesthesia. This involves filling the bladder with a liquid for stretching it to provide a closer view of the bladder wall. Usually, a urologist performs this surgery along with a gynaecologist. IC and also Hunner s ulcers are both a diagnosis of exclusion. This means that they re diagnosed only after a number of other conditions have been ruled out.

Hence, the urologist will first take your thorough medical history, followed by a physical exam and a pelvic exam for women patients and perform tests for ruling out infection, and other disorders like bladder stones and cancer, kidney disease, multiple sclerosis, endometriosis, sexually transmitted diseases amongst others. Only after these tests are inconclusive or uncertain and if there is blood in urine, will the urologist go for cystoscopy.

Treatment
There's no cure for IC, but Hunner s ulcers can be cured by burning them off the bladder wall. Called fulguration, the process uses electricity or laser to burn the ulcers on the bladder wall. Resection is also used in which skin from around the Hunner s ulcer is cut for removing both the ulcer and the inflamed tissue around it. The problem is that ulcers may recur in the same location.
So, managing IC becomes critical. Your doctor can try to treat the patient with one treatment or with a combination of treatment depending on the condition of the patient.

Pain medicines are the first line of treatment to manage Hunner s ulcers and IC both, and many patients do go in for this. Patients also find relief by modifying their diet to remove foods and drinks like caffeinated beverages- tea, coffee, colas etc. Sodas, artificial sugars and fruit juices, especially Cranberry juice can trigger intense pain and discomfort, so these are usually contraindicated. Another important aspect is patient education about normal bladder function and tips on self-care and behavioural modifications like stress control to manage Hunner s ulcers.

Hunner's Ulcer In Urinary Bladder - How They Can Be Treated?

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