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The What and Why of Overactive Bladders

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Overactive Bladder, or OAB is a condition characterized by moderate to complete loss of control of urination. Despite affecting a large number of adults worldwide, OAB, like most urinary conditions, largely remains undiagnosed primarily due to it being misunderstood as ‘a regular by-product of aging’. In this article, we’ll go over the causes of an overactive bladder and see how you can prevent it from happening.

How It Happens

According to urologists, In order to regulate urine volumes in the body, the bladder, aka the urine-storage organ, sends nerve signals to the brain by contracting its muscles in order to trigger and control urine release via contracting and relaxing the bladder and pelvic floor muscles. In individuals with OAB, the bladder muscles contract involuntarily even when it is half-full, resulting in urgent brain signals for untimely urination.


Experiencing at least two of these disruptive symptoms may indicate an overactive bladder:

  • Urinary Urgency: A sudden, uncontrollable urge to urinate.
  • Urge Incontinence: The inability to control, or an involuntary loss of urine, ranging from a few drops to excess urination, after experiencing an urge.
  • Frequent Urination: At least 8 or more times during the day without excess fluid intake.
  • Nocturia: Waking 2 or more times at night to urinate.

An infection in the blood or urine may lead to abnormal urges to urinate. Upon consulting a doctor he may check for signs of infection in both and may also want to make sure that your bladder is emptied completely when you urinate.

Your doctor will also look for additional clues that could indicate contributing factors. Therefore, your appointment will likely include him taking your medical history, a physical exam (for women this may also include a rectal exam or pelvic exam), a urine sample test to check for infection or other abnormalities and a focused neurological exam to identify any sensory problems or abnormal reflexes.

Tests of bladder function

Urodynamic tests may be ordered by your doctor. These tests assess the functioning of your bladder and its ability to empty steadily and completely. A specialist is typically referred to for these tests and the results may not be necessary to make a diagnosis or to begin treatment.

Urodynamic tests include a measuring of urine left in the bladder which is important especially when there are concerns about your bladder’s ability to empty itself completely while urinating. The remaining urine in your bladder, or post-void residual urine as it is often called, may be the cause for the symptoms you are experiencing rather than an overactive bladder.

An ultrasound scan may be required by your doctor to measure the residual urine in your bladder. An ultrasound scan utilizes sound waves to form an image of the area. This shows the amount of urine you have left in your bladder after you have voided. In some cases a thin tube, or catheter, may be passed into your bladder through the urethra to drain the remaining urine for measurement.


There are many causes of an overactive bladder. OAB is not one definitive diagnosis, but is usually the result of other factors and medical conditions, such as:

  • Excess caffeine consumption
  • Low estrogen, particularly after menopause
  • Incontinence resulting from difficult walking.
  • Stretched or weakened pelvic or bladder muscles
  • Multiple pregnancies involving childbirth via the vagina
  • Acute Urinary Tract Infections (UTIs) that affect the bladder’s functioning
  • Inability to completely empty the bladder at one time; usually common in older individuals
  • Nerve damage caused by diabetic neuropathy, making nerve signal transmissions difficult
  • Medications that either need to be taken with excess fluids, or that rapidly increase urine production
  • An enlarged prostate in men, chronic constipation, hip problems and surgery, or previous surgery for treating other forms of incontinence, as they interfere with urine excretion
  • Neurological disorders like stroke or multiple sclerosis, or diseases such as Alzheimer’s and Parkinson’s that cause cognitive function decline, hence making it difficult to understand urination signals sent by the brain


Along with physical problems, sufferers of OAB are also more likely to develop one or more of the following mental health and behavioral troubles, particularly if incontinence is life-disrupting:

  • Depression
  • Mild anxiety, such as fear of an accident or being far from the bathroom, or severe anxiety that usually involves complete avoidance of social situations for fear of sudden urges
  • Sleep Disturbance and sexual incontinence
  • Some individuals might also experience Mixed Incontinence, i.e. urinary urgency after putting physical stress or pressure, usually during strenuous exercise or running, on the bladder (also known as Stress Incontinence).


While treatment and complete recovery is possible with appropriate treatment, a large majority of OAB cases can be prevented entirely by making certain lifestyle changes:

  • Maintain a healthy weight
  • Exercise daily and regularly, while also including more physical activity in daily life
  • Consume caffeine in moderation
  • Stop or avoid smoking
  • Appropriately manage your chronic condition if you have one, such as maintaining your blood sugar in diabetes, in order to avoid the development of bladder-related complications

While chances of bladder overactivity do increase with age, it is by no means a normal part of aging. If you experience symptoms of OAB, or you notice any causes of an overactive bladder, consult with your doctor for adequate and prompt treatment. You can also book an appointment with a top Urologist in Peshawar, Karachi and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your urinary concerns.

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.

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