Ways to control an overactive bladder

Dear Dr G,

I am hoping you can help me with my problems of overactive bladder (OAB).

I am a sales executive in my late thirties and happily married to my wife for 10 years.

My wife started noticing some strange toilet habit I started developing during a recent family holiday to Japan.

I realised I started waking up at night for toilet visits to urinate, and the frequency has also extended to daytime in most days.

Occasionally, I also experienced urgency of urination, and on several occasions, I also nearly wet my pants.

I initially thought that I had contracted urinary tract infection (UTI) and had taken several courses of antibiotics.

Sadly, the symptoms persisted despite the medication and the doctors confirmed my urine was not infected.

I went to see a specialist where the urologist told me that I have overactive bladder (OAB) and not UTI.

In fact, he did ask me about my sexual activities. However, I was too embarrassed to tell him I also suffer from low libido and erectile dysfunction.

What exactly is OAB? And how common is this condition?

What are the common causes of OAB? Can OAB be treated?

Lastly, is OAB really related to sexual dysfunction? Or this is all in my head? Please help.

Yours truly,

Overactive Oliver

Overactive bladder (OAB) is a common condition characterised by a sudden and strong urge to urinate, frequent urination, and in some cases, urinary incontinence. Overactive bladder knows no bounds when it comes to age, gender, or demographic. It affects people from all walks of life, and from the young to the old. It is estimated OAB affects around 16% of men and 17% of women worldwide. It is estimated that around 15-20% of adults worldwide experience OAB symptoms at some point in their lives. However, the actual numbers may be higher as many individuals fail to seek medical attention due to embarrassment or misconceptions about the condition.

The exact cause of OAB remains unknown, although certain factors have been identified as potential contributors. These include age-related changes to the bladder muscle, neurological conditions, hormonal imbalances, urinary tract infections, and lifestyle habits such as caffeine consumption and inadequate fluid intake. Moreover, OAB can also be influenced by psychological factors like stress, anxiety, and depression.

OAB is a diagnosis of exclusion as the symptoms often mimic medical conditions such as urinary tract infections, neurogenic bladder, urinary calculus and even bladder cancer. Careful medical history taking, laboratory investigation and imaging will help to exclude other medical conditions before the proper diagnosis of OAB is made. As this can often delay the diagnosis of OAB, patients tend to be underdiagnosed and presented late with worsening symptoms.

Living with OAB can significantly impact an individual’s quality of life. This includes sleep interruptions with frequent toilet visits, and incontinence resulting in urinary leakages that impact the individual’s daily activities and lifestyle.

The exact link between OAB and sexual dysfunction in both men and women is not well documented. However, the fear of leakage during intimate moments, the constant need to use the restroom, and the psychological distress associated with the condition can all contribute to sexual dysfunction. It can lead to decreased sexual desire, difficulties with arousal, and even avoidance of sexual activities altogether. Furthermore, OAB can strain relationships, causing emotional and psychological distress for both partners.

A variety of treatment options are available that can help manage OAB symptoms and improve sexual function. These include lifestyle modifications, such as dietary changes, bladder training exercises, and pelvic floor muscle exercises. Medications that relax the bladder muscles or decrease bladder contractions may also be prescribed. In more severe cases, minimally invasive procedures or surgery might be recommended. Psychological support, counselling, and education are also crucial for individuals living with OAB. Addressing any psychological distress, providing coping mechanisms, and encouraging open communication with partners can significantly improve sexual function and overall quality of life.

Overactive bladder is a common condition that affects millions of individuals worldwide. The impact of OAB on the quality of life of individuals and their partners cannot be underestimated. The additional impact on sexual function should not be overlooked, as it can cause distress and strain relationships.

Recognising the prevalence, understanding the underlying causes, and seeking appropriate treatment can greatly improve the overall well-being and sexual health of those living with OAB.