How Can Overactive Bladder be Treated? Top Strategies and Medications

Key Takeaways:

1. Overactive bladder (OAB) is a combination of symptoms involving sudden and urgent need to urinate.
2. Treating overactive bladder requires a comprehensive approach involving lifestyle changes and medical treatments.
3. Possible medical treatments include medications, bladder retraining and surgery, while lifestyle changes involve limiting fluid intake, avoiding bladder irritants and scheduling regular bathroom breaks.

Introduction

Overactive bladder (OAB) is an umbrella term for a combination of symptoms that creates an urgent, sudden need to urinate. Symptoms of OAB include the need to frequently urinate at night, a strong sense of urgency to urinate and incorrect bladder contractions while voiding. Treating overactive bladder requires a comprehensive approach that involves both lifestyle changes and medical treatments.

Causes of Overactive Bladder

There are several underlying causes of OAB that can be divided into anatomical and neurological. Anatomically, OAB can occur when the bladder has an abnormal size or shape. In some cases, the bladder may be structurally too small to hold the amount of urine produced. This can lead to frequent and urgent urination. In other cases, the bladder may not contract correctly or muscles may be too tight, causing OAB. Neuromuscular or neurologic conditions, such as Multiple Sclerosis, Parkinson’s Disease or stroke, can also contribute to OAB symptoms. Lastly, dietary habits can play a role in OAB. Bladder irritant foods and drinks such as caffeine, acidic fruit juices, or alcohol can exacerbate or cause overactive bladder.

Medical Treatments for Overactive Bladder

Since overactive bladder can be caused by a variety of underlying factors, different treatment methods are available. Medications are often the first line of treatment and they work by increasing the capacity of the bladder, calming bladder contractions and weakening the urge to urinate. Anticholinergic medications, like oxybutynin, genifan, and tollcan, are some common OAB medications. In cases where medications don’t adequately reduce symptoms, bladder retraining may be needed. Bladder retraining is a type of physical therapy that teaches proper voiding techniques and can help you maintain control of your bladder. Lastly, more severe cases of OAB can be treated surgically. Procedures such as botox injections, nerve stimulation, and sacral neuromodulation all work to reduce the frequency and urgency of urination.

Lifestyle Changes to Help Manage Overactive Bladder
Making lifestyle changes can also help manage OAB symptoms. Limiting the amount of fluids you drink and avoiding foods and drinks that can irritate your bladder is one way to reduce symptoms. Scheduling regular bathroom breaks can also help as it gives you an opportunity to empty your bladder when it is full. Lastly, performing pelvic floor muscle exercises can help strengthen and relax the muscles in the pelvis and can be used in combination with medications or other treatments.

Conclusion

In conclusion, overactive bladder is a condition that can have a range of underlying causes. Treating OAB requires a comprehensive approach that combines both lifestyle changes and medical treatments. Medications, bladder retraining, and surgery are all viable medical treatment options. Lifestyle changes such as limiting fluids, avoiding bladder irritants and scheduling regular bathroom breaks can also help reduce symptoms. If lifestyle changes and medical treatments don’t provide relief, it is important to seek professional help.

At St Pete Urology, our board-certified urologists are dedicated to helping our patients overcome overactive bladder and other urological symptoms. Our goal is to provide the highest quality of care in the diagnosis, prevention and treatment of urinary conditions to all the patients we serve. To learn more, contact the St Pete Urology office today and start on your journey to better bladder health.

References:

What are the four main symptoms of an overactive bladder?

The bladder is a hollow organ located in the abdomen that temporarily holds urine produced by the kidneys. As the bladder fills with urine, nerve signals are sent to the brain, which causes the urge to urinate. These signals from the brain coordinate the relaxation of pelvic floor muscles and urethral sphincter muscles. Then, it directs the bladder muscles to contract and expel urine through the urethra.

An overactive bladder is a condition in which there is a loss of coordination of bladder muscles. The muscles responsible for urination have the remarkable ability to initiate contractions independently, even without direct signals from the brain. This intrinsic capability allows these muscles to expel urine through the urethra. This is a process that can occur even when the volume of urine in the bladder is relatively low. This results in an urgent, uncontrollable need to urinate, and may lead to urine leakage if a bathroom cannot be reached immediately. There are two types of overactive bladder: a dry form that occurs without an overwhelming urge to urinate (hence no urine leakage), and a wet form that is characterized by an uncontrollable need to urinate (therefore, leakage or involuntary voiding occurs).

Overactive bladder is a common problem, especially in older adults (though it is not a normal result of aging). It affects 1 in every 11 people in the United States, mostly those aged 60 and older. However, women may be affected earlier, often in their mid-forties.

The four main symptoms of an overactive bladder are:

Frequent urination:

Also called urinary frequency, this refers to an urge to urinate that is more frequent than usual. Urinary frequency can disrupt a normal daily routine or interfere with sleep. For example, while most people urinate 6-7 times per day after consuming about 2 liters of fluid, someone with urinary frequency may urinate 8 or more times within 24 hours.

Urgency:

Urinary urgency refers to a sudden, uncontrollable urge to urinate. It is caused by involuntary contractions of bladder muscles and feels like painful straining. Uncontrolled loss or leakage of urine may follow if a person is not able to urinate immediately. It tends to occur alongside, and is usually related to, urinary frequency.

Nocturia:

Waking up at least once each night to urinate is called nocturia. Normally, a person should be able to sleep for 6-8 hours without having to wake up to go to the bathroom. However, when a person has an overactive bladder, involuntary contractions of the bladder may occur at any time at night, leading to the need to wake up more than once every night to urinate. This can disrupt the normal sleep cycle and impact quality of life.

Unintentional loss of urine:

The strong, sudden, and uncontrollable urge to urinate that occurs in people with an overactive bladder is often followed by accidental loss or leakage of urine. This is because a person is not usually able to hold the urine long enough to reach the bathroom. Leakage of urine can be embarrassing and may force a person to avoid normal social or routine activities.

There are a number of effective treatments for an overactive bladder. These include behavioral strategies such as dietary changes, fluid schedules, prompted and timed voiding, bowel programs, and absorbent garments. However, if the symptoms of urinary incontinence become notably distressing or significantly disrupt one’s daily life, a doctor can opt to prescribe medications as part of the treatment plan. These medications may include antispasmodics or anticholinergics, such as tolterodine (Detrol), oxybutynin (Ditropan), oxybutynin skin patch (Oxytrol), trospium (Sanctura), or solifenacin (Vesicare). Their purpose is to reduce the number of urge episodes experienced by the individual.

An alternative treatment option is the sacral nerve stimulator. In this procedure, a pacemaker-type device is surgically placed under the skin of the abdomen. It is then connected to a wire that is positioned near the sacral nerves, which are located near the tailbone. This device can help regulate the bladder muscles and reduce the number of involuntary contractions.

It is important to see a doctor if you are experiencing symptoms of an overactive bladder, as it is a treatable condition. The doctor can help determine the underlying cause and recommend the appropriate treatment. In some cases, underlying medical conditions, such as urinary tract infection, may be contributing to the symptoms, and treating these conditions may improve bladder control.

Conclusion

In summary, an overactive bladder is a condition in which the bladder muscles contract involuntarily, leading to a strong, urgent need to urinate. This can cause frequent urination, urinary urgency, nocturia, and unintentional loss of urine. Urinary incontinence is more frequently observed among older adults. However, it’s important to note that it is not a natural consequence of aging. Fortunately, there are several effective methods available for managing and treating this condition. These methods encompass a range of approaches, including behavioral strategies and the use of medications. If you are experiencing symptoms of an overactive bladder, it is important to see a doctor for a proper diagnosis and treatment plan.

For more information on symptoms, diagnosis and treatment of an overactive bladder and other urological disorders, visit the site “St Pete Urology.”

10 Ways to Stop Leaks in Urinary Incontinence

Urine leaks due to urinary incontinence can be stressful and embarrassing. Persistent loss of urine may make you feel wet, dirty and uncomfortable. In turn, many feel they have to restrict their social and physical activities, including shopping, exercise, dancing, or visiting friends. 

Also, many may experience low self-esteem, body negativity, low physical attractiveness, inadequacy, and reduced sexual desire, which tragically can lead to self-isolation, loneliness, and depression. Plus, accidental urine leaks can compromise daily life activities as you have to continually interrupt your life to use the bathroom. 

There are a number of effective treatments for urinary incontinence, including medications, electrical stimulation, medical devices, and surgery. But there is also a lot you can do to reduce the risk of urinary incontinence and to avoid accidental leaks. 

Here are 10 ways to stop leaks in urinary incontinence.

  1. Increase your fluid intake

Drinking enough water makes your urine less concentrated. This prevents bladder irritation and minimizes urinary urgency that is usually the immediate cause of urine leakage.

So you shouldn’t stop drinking more water when you have urinary incontinence. Instead, make sure to drink 6-8 ounce glasses of water a day. 

An easier way to know you’re drinking enough water is to monitor the color of your urine. Pale yellow urine means adequate hydration, while darker yellow suggests you should drink more.

  1. Empty your bladder regularly

Visiting the bathroom on schedule, every 2-3 hours, even when you don’t feel the urge to pass urine is effective in preventing urine leaks. The strategy keeps urine volume in the bladder low enough to stop accidental leaks.

Another strategy is to always empty your bladder before you leave your house or other venue, like a restaurant or office, even when you don’t feel the urge to go. This will reduce the chances of having an uncontrollable urge to urinate as you travel or go about your routine.

  1. Know where bathrooms are located

When in a new, unfamiliar destination, such as a museum, restaurant, shopping center or park, make sure to know the location of the bathroom. This will enable you to reach the bathroom as soon as you feel the urge to urinate and reduce the chances of accidental leaks. 

  1. Keep a bladder diary

If you want to understand the triggers and patterns behind your urinary incontinence, tracking your bathroom habits using a bladder diary is an effective method. In fact, a few days before you visit your urologist, you should start keeping a diary.

Write down what you drink, the time you drink it, the number of times you pass urine, and whether you’ve had urine-leaking episodes. Also, indicate everything that might have caused the accidental leakage, such as exercising, coughing, or a sense of urgency.

  1. Engage in Kegel exercises

Pelvic floor muscle exercises, called Kegels, help strengthen bladder-supporting muscles and in turn prevent urine leaks and urinary urgency due to overactive bladder. 

Kegels are quite easy to do. For instance, you can simply tighten or squeeze your pelvic floor muscles (muscles that you use to stop urine flow or the passing of gas) for a count of three, then relax them slowly for a count of three. Build up to doing 10-15 squeezes, 3 times a day, and see your bladder control improve within 6 weeks.

The good thing with Kegels is that you can do the exercise any time, at your desk at work or while sitting in your car. 

  1. Lose weight

Losing weight removes the extra pressure on your bladder and pelvic muscles, which can cause accidental leakage. Losing up to 20 pounds of weight over a period of say 6 months can cut bladder leaking episodes by nearly 50 percent.

  1. Cut down bladder-irritating drinks and food

Certain drinks and foods may irritate the lining of your bladder and cause an overwhelming urge to urinate, which may be followed by accidental leakage. For instance, caffeine and alcohol are top bladder irritants. And by limiting alcohol and caffeine beverages, such as tea, coffee, and cola you can prevent urine leaks.

 Also avoid bladder irritants such as apples, apple juice, artificial sweeteners, carbonated beverages, chili and spicy foods, chocolate, citrus fruit and juices, milk products, cranberries and cranberry juice, pineapple, tomatoes, sugar and honey, and vinegar. 

A good strategy is to try eliminating one or more potential irritants from your diet for 2 weeks, the reintroduce them one by one every few days to see if there is a noticeable difference in your urge to pee, how often you go, and the number of leaks you’ll experience.

  1. Quit smoking

Smoking makes you more vulnerable to urinary incontinence by damaging the small blood vessels in your body and causing tissue weakness. Also, smoking can cause coughing, which may lead to urine leakage by increasing pressure on the pelvic floor muscles. 

Plus, cigarette smoking can triple your risk of bladder cancer, which has one of its symptoms as the need to urinate more often or an uncontrollable urge to urinate, even when the bladder is not full.

  1. Review your medications

Some medications can promote urinary incontinence. For example, diuretics increase urine production by the kidneys while muscle relaxants and sedatives relax the urethra and increase the need to pee.

When you suspect your drugs as culprits in your urinary incontinence, speak with your doctor about it. Your physician will determine if the dosage should be changed, if alternatives could be used, or if you should stop taking them.

  1. Treat constipation promptly

With constipation, your colon swells and strains due to excess abdominal muscle pressure. The continuous straining to pass stool weakens pelvic floor muscles and makes urinary incontinence worse. In turn, bladder muscles are adversely affected and the severity of urinary incontinence increases.

Eat more fiber to prevent constipation. Equally, exercise regularly and drink plenty of water. And if you have chronic constipation, speak with your doctor for recommendations on how to manage it, including taking medications or trying physical therapy.

Are you bothered by urine leaks? At St Pete Urology, we encourage you to make the above simple changes to strengthen your bladder and pelvic muscles, reduce bladder irritation, and improve your urinary incontinence symptoms.  If urine leakage persists, see your urologist to determine the underlying cause and develop a tailored treatment for you.

For more information on urinary incontinence and other urological problems, visit the site “St Pete Urology.”

Common Bladder Control Problems

Tonight we’re going to talk about bowel and bladder control primarily. So Dr. Graves and I both actually trained together at the University of Pennsylvania in Philadelphia and we’ve been each practicing for close to 10 years. And we’ve had five years of urology training in residency and med school before that.

And the topic tonight is something that we do have a lot of focus in and enjoy taking care of and have specialty in. All right so there’s three kind of categories to kind of simplify this about bladder control issues. One is stress incontinence and I’ll describe that more in the next slides. The second is urinary retention which is the inability to actually get urine out where the urine is trapped in the bladder and you can’t fully empty the bladder and the third is overactive bladder. 

So stress incontinence is the kind of incontinence that some patients can have in which when you increase the pressure on the bladder it overcomes the ability of the sphincter to control the urine. So sneezing, coughing, laughing, standing up real quick after you’ve been sitting for a while, climbing up things like stairs, exercising and then you get a dribble or even sometimes a full emptying of the bladder as you do those activities so that’s deemed stress incontinence. And that is an issue typically with the sphincter itself and the pelvic floor with the inability to control the bladder from emptying. And that’s an issue that some women have with age or after childbirth that can occur. In regards to men that would be something that sometimes we see after prostate type procedures and then also you know something with the age that can occur. In regards to urinary retention that’s when you can’t fully empty your bladder. Sometimes patients will show up with to the emergency room or our office with the inability to empty their bladder and they need a catheter put in to drain the bladder. Other times it could be a slow chronic situation where they don’t empty the bladder fully and it builds up into a inability to empty. That’s actually dangerous because you’re not able to clear all the toxins out of your body and you can get infections or kidney failure, this is something that’s important to tease out. Usually in these cases you can have leaking but the main symptom is difficulty emptying and a weak stream. And then overactive bladder is is a quite common situation in which you have a bladder that isn’t able to hold urine for the amount of time it should in between urination. So you get frequent trips to the bathroom with strong urges to pee even though you just urinated, went to the bathroom and peed you know 20 minutes 30 minutes later you feel like you got to go again and are heading back to the bathroom. And that can sometimes progress into urge incontinence which is a type of leaking of urine as opposed to the stress incontinence where you sneeze cough strain and leak this is where you get a strong urge to pee and you can’t hold it back and then you end up having a leak before you make it to the bathroom in time.

And then a different kind of incontinence would be this fecal incontinence which is basically bowel incontinence and this is not urinary incontinence but a situation in which you have control issues with having bowel movements. So you can actually have loss of control where you have accidents with your stool sometimes that could be this like a strong urge that you cannot control or other times it’s a loss of feeling that you have to go and you can have either small accidents or a full incontinent episode with fecal incontinence

What Can Cause Poor Bladder Control?

Loss of bladder control, called urinary incontinence, is a common and usually embarrassing problem. It may manifest as leaking of urine when coughing, sneezing, jumping, or during other physical activity. But it can also occur as a sudden, strong, uncontrollable urge to urinate or wake up several times at night.

While the problem tends to occur more commonly in older people, it isn’t an unavoidable consequence of aging. In fact, you don’t have to live with urinary incontinence because you are aging.

So if urinary continence is disrupting your social life and daily routine or affecting your quality of life, speak with your doctor about it. Your urologist will usually begin with a conservative approach of recommending simple lifestyle and dietary changes to help you get relief from the symptoms. Or in some cases the doctor may recommend more aggressive medical treatments to free you from the condition.

Causes of Poor Bladder Control image

Types of urinary incontinence:

  1. Stress incontinence
    Stress incontinence occurs if exerting direct pressure on your bladder results in urine leakage. The urine leaks linked to stress incontinence typically occur when you cough, sneeze, laugh, exercise or lift a heavy item.
  2. Urge incontinence
    Urge incontinence manifests itself if you frequently experience a sudden, intense, uncontrollable urge to pass urine which results in urine leakage. With the strong urge, most find themselves urinating several times per day including throughout the night.
    Urge incontinence may be due to a minor condition, such as urinary tract infection. But it some cases it can be the result of a more severe condition such as diabetes or a neurological disorder.
  3. Overflow incontinence
    Overflow incontinence is when you experience frequent dribbling of urine. Usually the dribbling of urine is due to the inability to fully and completely empty the bladder.
  4. Functional incontinence
    Functional urinary incontinence is the result of physical or mental impairments that makes it difficult to hold urine and for many to even reach the toilet in time to relieve themselves. So many have urine leaking from their bladder as they struggle to reach the bathroom. 
  5. Mixed incontinence
    Mixed incontinence is if you suffer from more than one type of urinary incontinence. Most often mixed incontinence is a combination of urge and stress incontinence.

What can cause poor bladder control?

Many experience urinary incontinence due to an underlying medical condition, a physical problem, or a change in lifestyle.  The incontinence may be temporary if due to a change in daily habits and in those cases is an easily treatable condition. But if the condition is persistent when related to a medical condition or physical problem, undergoing a thorough evaluation by your doctor will help determine the cause of your incontinence.

Causes of temporary urinary incontinence:

  • Urinary tract infections
    Urinary tract infections may also lead to a strong urge to urinate. The urge may be too intense to the point of urine leakage before you can reach the bathroom. With the treatment of the source infection, the incontinence typically disappears.
  • Constipation
    Since the rectum is located near the bladder and shares many nerves with the bladder, having hard, compacted stool in the rectum can cause the nerves controlling the bladder to be overactive. In turn, increased urinary frequency may occur, resulting in incontinence. The incontinence usually resolves when the constipation ends.
  • Drinks that act as diuretics
    Some drinks have the ability to stimulate the bladder and increase urine volume. As a result, urine may leak due to the overwhelming volume in the bladder. Reducing the intake or avoiding these drinks helps to prevent incontinence.

    The drinks include: 

    • a. Caffeine
    • b. Alcohol
    • c. Artificial sweeteners
    • d. Chocolate
    • e. Carbonated drinks and sparkling water
    • f. Chili peppers
    • g. Large doses of vitamin C
    • h. Sedatives, muscle relaxants, and heart and high blood pressure medications
    • i. Foods with too much sugar, spices, or acids, particularly citrus fruits

Causes of persistent urinary incontinence:

  • Pregnancy
    Pregnancy is accompanied by hormonal changes and increased weight of the fetus. These changes may cause stress incontinence.
  • Childbirth
    During vaginal delivery, the muscles that control the bladder may weaken. The nerves and supporting tissues may also be damaged.  Due to the weakening of bladder muscles and damage of nerves and tissues, a prolapse (dropped) may occur in the pelvic floor. 
    Following a prolapse—where the bladder, rectum, uterus or small intestine is pushed down from the normal position and protrudes into the vagina—bladder control diminishes, resulting in incontinence.
  • Aging
    With age, the bladder muscles weaken and bladder control reduces. Also, as you get older, involuntary bladder contractions become more common, increasing the likelihood of incontinence.
  • Menopause
    The production of estrogen—a hormone that keeps the lining of the urethra and bladder healthy—reduces after menopause. As a result, the bladder and urethral tissues deteriorate, causing or aggravating incontinence. 
  • Enlarged prostate
    Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. As the prostate enlarges, it puts more pressure on the bladder, which in turn loses control. Thus, an enlarged prostate often triggers urinary incontinence.
  • Prostate cancer
    Untreated prostate cancer can cause stress incontinence in men. Also, urinary incontinence may be an adverse effect of prostate cancer treatment.
  • Urinary tract obstruction
    Overflow incontinence can occur when there is a blockage of the normal flow to urine along the urinary tract. The obstruction may be due to a tumor somewhere in the urinary tract or a urinary stone.
  • Neurological disorders
    Disorders that interfere with the nerves involved in bladder control may trigger urinary incontinence. Neurological issues commonly associated with urinary incontinence include stroke, multiple sclerosis, Parkinson’s disease, brain tumor, and spinal injury.

When should you see a doctor?

Please see a doctor if urinary incontinence is too frequent, embarrassing, and is affecting your quality of life. Your doctor will identify the underlying cause of the problem and administer appropriate treatment. 

Plus, you should see a urologist when the incontinence:

  • Causes you to restrict your social interactions and daily activities.
  • Adversely affects your esteem, confidence, and quality of life.
  • Is accompanied by other symptoms, such as pain or blood in urine.
  • Could pose other risks, such as the risk of falls as you rush to the toilet.
  • Is suspected to be a symptom of a more serious underlying condition.

At St Pete Urology, we have a team of urologists that boasts a rich knowledge and wealth of experience in treating urinary incontinence.  Our urologists conduct a thorough physical exam and take comprehensive medical history before requesting appropriate tests to help identify the underlying cause of incontinence.

We are proud of our tailored treatments and the remarkable results we achieve with all our patients. For more information on urinary incontinence and other urological problems, visit the site “St Pete Urology.”

What Can Cause Incontinence

Tonight we’re going to talk about bowel and bladder control primarily. So Dr. Graves and I both actually trained together at the university of Pennsylvania in Philadelphia. And we’ve been each practicing for close to 10 years and we’ve had five years of urology training in residency and med school before that. And the topic tonight is something that we do have a lot of focus in and enjoy taking care of and have specialty in. So what causes incontinence of urine or stool there’s a huge host of things that something your doctor can figure out but sometimes it could be something you know is simple. If it’s mild like what you’re eating an excess amount of caffeine it can do that. Some people will be drinking an excessive amount of coffee, you know, I talk to some patients they’re drinking a pot of coffee a day. Other times it really has nothing to do with their diet, medications can do that certain diuretics can predispose to issues with urinary control. If you’re not as physically fit bedridden have other physical mobility issues sometimes that can deal with causing incontinence. And then other things can increase your risk like radiation of the pelvis before a prior injury to the spinal cord or your pelvic floor, certain pregnancy issues or childbirth like such as vaginal deliveries sometimes can have something to do with that. Complicated in terms of regards to different causes but something that is often easy to figure out when you see a physician.

How Does Bladder Bowel Control Work

Tonight we’re going to talk about bowel and bladder control primarily, so Dr. Graves and I both actually trained together at the University of Pennsylvania in Philadelphia. And we’ve been each practicing for close to ten years and we’ve had five years of urology training in residency and med school before that. And the topic tonight is something that we do have a lot of focus in and enjoy taking care of and have specialty in.

So bladder control is something we’ll discuss about the pathophysiology and how that works. So your kidneys filter your blood and make urine and then it goes into the bladder where it’s stored and then you pee that out. And you’re supposed to be able to control that and the bladder’s in muscle. And when the bladder gets full basically it’ll send a signal and you’ll get relaxation of the external sphincter, which is a sphincter control to control the urine. And then allow the sphincter to open and then the bladder squeezes down and drains the bladder. But this is a complex system and it does require basically the brain and its ability to inhibit the need to urinate and the ability to control relaxation. The sphincter and the spinal cord so it’s a pretty exquisite and very detailed system, but it’s something that different areas of that process can have an issue that could be fixed or could be the cause of the incumbents. And then the bowel control is very similar instead of a bladder you have intestines and a colon and a rectum where a stool is stored. And there is a sphincter as well that controls your ability to hold the stool in place and again that involves the brain the spinal cord and the the muscle of the rectum and the colon involved for bowel control you

Understanding Bladder and Bowel Control

Tonight we’re going to talk about bowel and bladder control primarily, so Dr. Graves and I both actually trained together at the University of Pennsylvania in Philadelphia. And we’ve been each practicing for close to ten years and we’ve had five years of urology training in residency and med school before that. And the topic tonight is something that we do have a lot of focus in and enjoy taking care of and have specialty in. 

So really we’re going to be dealing with two main things: that’s problems with number one and number two, so issues with urinary control and bowel control today. And actually I still remember one of the main reasons I went into urology was because I wanted to help people with quality of life issues. And often having issues controlling either urination or your bowels can be embarrassing and difficult to talk about. And a lot of patients I’ll even deal with for other reasons and they just don’t want to talk about it because they’re just embarrassed. But it’s very common and as patients even young patients can have issues but as we get older they can become more prevalent, but we want to create awareness about it and let you know that you can talk to your physicians, doctors and urologists about it and there are solutions and it’s not something you have to live with. 

So just a quick outline of what we want to talk about today is understanding the bladder and bowel control better today, the care pathway for these different treatment options. And then we can also talk about how medtronic has different treatment options such as inner stem, another type of treatment called neuro, and we’ll discuss those in detail and then we’ll open it up for some questions. So if you’re having bowel and bladder issues you’re not alone, it’s very common and one in six adults can have an overactive bladder. And we’ll discuss what that means so OAB is often referred to as overactive bladder. 

So you have about 37 million Americans who have an overactive bladder and that’s where you have urinary frequency, urgency, difficulty with controlling urination when you want to, and that can even have incontinence where you actually can have urinary incontinence and lose control of your urine. And then one in 12 adults can have fecal incontinence and that’s loss of control of having a bowel movement so that can be very distressing for patients. And this is quite common just to compare there’s 12 million patients in the U.S with vision problems and 17 million patients with asthma so it’s even more prevalent than that.

Why Do I Pee So Much

Key takeaways

  • The frequency of peeing can be used to monitor overall health and anticipate certain problems. A regular peeing rate and volume occur when a person is well-hydrated and there is no undue pressure on the pelvic floor, bladder, and kidneys. A normal range is 5-8 voids in 24 hours and no more than twice at night if over 60 years old.
  • Nocturia, or frequently peeing at night, can be caused by decreased production of anti-diuretic hormone (ADH) with age or a lack of production in children. It can also be caused by drinking too much water, taking diuretic medications, untreated diabetes, urinary tract infections, or an overactive bladder.
  • It is important to speak with a medical professional if experiencing frequent or urgent peeing as it can be a symptom of underlying health issues.

Peeing can be an inconvenience when it gets more frequent and urgent.

The good news is that you can use your frequency of peeing to monitor how your body works. You can use it to assess your overall health and anticipate certain problems.

What is considered normal when it comes to peeing?

A regular peeing rate and volume occur when you are well-hydrated. There is no undue pressure on your pelvic floor, bladder, and kidneys. It means that you can anticipate when and how frequently you visit the bathroom.

When healthy, a good peeing range is 5-8 voids in 24 hours. At night, you shouldn’t wake up more than twice to pee if you are over 60 years old. When you pee more than eight times in 24 hours, that could mean that you have an overactive bladder.

The amount of urine you pass depends on how much fluid you drink, how big your bladder is, and how much urine your body produces.

Your body makes roughly 3 liters of urine each day. If you have a normal, healthy bladder,  you can hold 300-400 ml of urine (approximately 2 cups). The urge to pee should generally start when your bladder has 150ml of urine (just over half a cup).

What is nocturia?

Peeing frequently at night is called nocturia. It means you have to wake up more than once a night to go to the bathroom.

The body usually produces more anti-diuretic hormone (ADH) at night, which prevents your kidneys from filtering and releasing water until you wake up. With normal ADH, you shouldn’t have to struggle to hold urine through your sleep.

However, ADH production decreases with age. That is why older adults are at higher risk of nocturia than younger adults.

ADH takes more time to be produced in children. That is why children below six years tend to wear diapers at night because they can’t hold pee overnight.

What causes peeing too much?

  1. Drinking too much water

The more fluid you drink, the more urine you make, and the more frequently you need to pee. You can tell if you are drinking enough by checking the color of your urine. If your pee is light yellow to clear, then you’re taking in enough fluid.

But if your pee is always clear and you spend a lot longer in the bathroom, then you are probably drinking too much. Though drinking too much fluid isn’t dangerous, you can ease the amount to reduce your visits to the toilet.

  1. Accidental or therapeutic use of diuretics

Diuretic medications help your body to get rid of excess fluid. The drugs work by prompting the kidney to be more permeable to sodium. This allows more sodium in the urine, which draws more water out of the blood into urine, lowering your blood pressure.

Diuretics are used as medications for high blood pressure. You should expect to pass urine a lot more when on these medications.

Drinks such as coffee, tea, and soda can act as diuretics, increasing your peeing frequency.

  1. Untreated diabetes

Untreated diabetes means a continually high level of glucose in your blood. Since your kidneys can’t handle the re-absorption of this extra glucose, it is excreted in the urine.

The presence of glucose in your urine draws additional fluids along with the glucose, resulting in an increased peeing rate. And as you lose more fluids, your body becomes dehydrated, and you feel thirstier than usual. You will end up drinking and peeing a lot more.

  1. Urinary tract infections

Urinary tract infections occur when bacteria enter via the urethra and multiply anywhere in your urinary tract. As the bacteria multiply, usually in the bladder, inflammation, and irritation increase the urge to pee.

In some cases, the bladder can become inflamed without an infection. This type of inflammation results in a chronic condition called interstitial cystitis or painful bladder syndrome, which is more common in women.

  1. Overactive bladder

Characterized by a sudden urge to pee that you can’t control, an overactive bladder occurs when signals from the brain fail, causing bladder muscles to want to squeeze out urine when it isn’t full.

This condition is an urge-related form of urinary incontinence, wherein suddenly you feel the need to pee, but not much comes out.

Overactive bladder is more common in people with neurological disorders, such as multiple sclerosis, stroke, Parkinson’s disease, dementia, or a bladder abnormality like bladder tumor.

These diseases tend to cause damage to the nerves that tell the bladder muscles when to contract.

  1. Urinary incontinence

Urinary incontinence is a condition where muscles that close off the urethra become weak, causing stress-inducing urinary leakage. The leaks may occur when you’re sneezing, coughing, or during strenuous exercise.

Incontinence may be due to pregnancy and childbirth, which weaken pelvic floor muscles.

Additionally, lower estrogen levels after menopause can also cause tissues to deteriorate in the urinary tract, resulting in incontinence.

  1. An enlarged prostate

For men with an enlarged prostate, there may be a constant feeling of needing to pee.

The growing prostate puts pressure on the urethra. It blocks the flow of urine, making the bladder work harder to expel the urine. The leftover urine can become a breeding ground for bacteria and lead to inflammation, further messing with the bladder.

  1. Pregnancy

When pregnant, blood volume increases, and the kidneys have to work through the excess fluid. This means that more fluid ends up in the bladder, and you can pee too much.

Increased frequency of peeing starts in the first trimester and gets worse in the subsequent trimesters.

What are the solutions to frequent peeing?

Frequent peeing can be reduced by cutting out bladder irritants from the diet. You can do so by avoiding alcohol, caffeine, artificial sweeteners, citrus, and spicy foods.

You should also quit smoking and lose weight. And drink most of your fluids earlier in the day to avoid trouble at night.

Peeing too much can be treated using medications. You can take medications that relax the bladder and its nearby muscles, such as antidepressants imipramine (Tofranil) and duloxetine (Cymbalta).

You can also get a Botox injection into your bladder. This will give temporary relief by paralyzing the muscles and blocking the chemical messenger acetylcholine, which sends signals to your brain to trigger abnormal bladder contractions associated with an overactive bladder.

Anti-cholinergic drugs, such as Oxybutynin, also block acetylcholine.

Pelvic floor physiotherapy is also ideal for stress-related incontinence, like pregnancy-linked incontinence.

But when incontinence occurs after menopause, estrogen creams may help by restoring the tissues near the urinary tract.

Bladder training is effective in controlling frequent peeing. It involves trying to go longer and longer without peeing over time.

For instance, if you go every hour, you can extend that time by 10 minutes for some days. Then keep adding on 10 minutes until you find yourself holding your pee for a longer period.

Safe, effective treatment of urinary incontinence

If you are peeing too much, you should see a urologist to determine the cause and degree of incontinence you have.

At St Pete Urology, we’ve helped many patients recover from leaky bladders through our tailored treatments.

Our solutions include behavioral therapies, pelvic muscle rehabilitation, incontinence devices, medication, Botox injections, and surgery. Our doctors have vast experience in diagnosing urinary incontinence and in providing the most appropriate treatments.

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