Among the common difficulties that men - and even women - experience as they get older are problems with the waterworks. Studies suggest that about one in six people over the age of forty experiences a condition termed Overactive Bladder(OAB)or Urgency – a sudden, compelling need to pass urine precipitated by a fear of leaking. The condition may be associated with Urge Incontinence (involuntary leakage of urine after a feeling of urgency), Frequency (having to pass water too frequently) and Nocturia (having to wake more than once or twice in the night to pass urine). It is sometimes referred to as Irritable Bladder.
In simple terms, an overactive bladder does not cause pain – and if one experiences pain or a burning sensation on passing urine, then a diagnosis other than Overactive Bladder needs to be considered.
Sadly, this condition though common is under-diagnosed and inadequately treated. To make sure it is an Overactive Bladder that is causing the symptoms rather than other similar diseases that can produce urinary symptoms (such as diabetes, urine infection and simply drinking too much fluid), it is useful to maintain a ‘Voiding Diary’ for three or four days. Every time one goes to the toilet to pass water during these days, a note should be made of the time, the amount of urine passed and whether urine involuntarily leaked. Measurement should also be recorded of the amount of liquid drunk. An adequate intake for an adult is approximately 1.5 litres per 24 hour period. One of the commonest causes of having to urinate a lot is Polydipsia (which in non-medical jargon simply means drinking too much fluid!)
If the Voiding Diary does indicate that one is passing urine more frequently than one should or that the intervals between voiding are shorter than they should be, this is an indication that a doctor should be consulted. After performing a physical examination, the doctor may then arrange an ultrasound scan to check whether the bladder empties adequately or if there is some narrowing or obstruction of the bladder outlet (like an enlarged prostate gland).
If no mechanical obstruction is found and diseases that needs treatment (like diabetes) are excluded, symptoms may be controlled by training the bladder muscles and toning the pelvic muscles utilising a course of pelvic floor exercises. In some instances, the physician may recommend one of several medications that are available for this condition – tablets like oxybutinin, amitryptiline, solfenacin etc. These work on the nerves acting on the muscles of the bladder and control emptying of the bladder.
Anyone who feels he may have symptoms of an Overactive Bladder should talk to his doctor. It is NOT a “normal” part of ageing that one has to put up with as one get older.
More information: Continence-FDN
