Am I an OAB person / Am I Managing UI Properly?

 By Dr. Veena G.D.

Urinary Incontinence / OAB occur because of problems with muscles and nerves that help to hold or release urine. The body stores urine (water and wastes removed by the kidneys) in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body. Usually this is noticed or experienced around third or fourth decade of life. OAB / UI incidence is higher in female population than in male.

Bladder emptying is a normal activity in our life. Sometimes this activity presents itself in altered status as a symptom with other conditions. So before letting the situation multiply, one must overcome personal hurdle and social taboo and must approach a remedy.

About two-thirds of those with OAB have "dry" OAB, in which they feel bladder contractions and have a sudden urge to urinate but do get to the bathroom on time. Wet OAB is embarrassingly self-explanatory. Take the quiz below to know whether you are in OAB category and accordingly consult concerned Gynecologist or Urologist.

1. Do you often feel the sudden and uncontrollable "urge to go" during the daytime?
   Yes / No
   On an average, a person needs to empty the bladder eight to ten times each day. People with overactive bladder feel like they need to urinate more often, probably 12 – 14 times or more. Tips:
   
   • Control liquid intake.
   • Avoid excess intake of coffee, tea, tetra packed juices and soft drinks as Caffeine and Nicotine are known diuretics (increases bladder frequency).
   • Plan and time your bathroom visits to take care of frequency and urgency. Thereby avoiding embarrassing situations.
   • If on medication, consult the doctor to know whether it can produce bladder irritation, so that it can be replaced with another.
   
    

2. Do you often have to get up at night to go to the bathroom?
   Yes / No
   Repeated waking up in the night disturbs the sleep pattern and may lead to insomnia. So it will be better to cut down the liquid intake and avoid caffeine and alcohol by about 6 – 7 pm, so that the bladder is empty by the time you go to bed.

3. Does accidental wetting happen to you quite often?
   Yes / No
   Overactive bladder does not always cause urinary leakage, but if leakage is there it might be most distressing symptom. Most of the women wear pads to cope with this problem. Reducing on liquid diet will also help. You may be on some medication that contributes to your bladder problems. If so, consult your doctor.

4.  Do you have enough energy throughout the day?
   Yes / No
   Poor sleep and day to day stress take a toll on energy levels. Plus they contribute to an overactive bladder. Cutting caffeine and alcohol is critical. You may also need to reduce stress in your daily life. Make sure you're relaxing yourself enough and practice good sleep habits.

5. Do your daily activities get interrupted due to OAB ?
   Yes / No
   An overactive bladder can be very disturbing. It may feel embarrassing in meetings, restaurants, grocery stores or shopping malls because finding a bathroom quickly and discretely may not be always easy. Your Precautions: Time your liquids carefully. In new surroundings, quickly familiarize yourself with bathroom locations. Take a bathroom break before work or meeting starts.

6. Do you often avoid social activities due to OAB ?
   Yes / No
   Remember, it's too easy to become isolated, which makes life less satisfying. If you want to avoid medication for your overactive bladder, you may discuss your options with your doctor. There may be lifestyle changes or coping strategies you can use. Few tips: Buy concert or sports seats near bathrooms. Curtail your liquid intake 3 - 4 hours before leaving the house. At your destination, take a bathroom break.

7. Are you taking medication for your overactive bladder ?
   Yes / No
   A class of drugs called anticholinergics can help control the urges of overactive bladder. They work by relaxing the bladder muscle. These drugs include Detrol, Detrol LA, Ditropan, and Sanctura, with few side effects like dry mouth and constipation. Oxytrol is available to treat overactive bladder and comes as in patch form. Newer drugs like Enablex and Vesicare are also effective in controlling the bladder with fewer side effects.

8. Do you do exercise or undergo small lifestyle changes for OAB ?
   Yes / No
   Kegel exercise (Pelvic Muscle exercise) help build strength in Detrusor muscle that controls the bladder. It is important to learn to do these exercises correctly. A Gynecologist will advice the proper way to exercise so as to get maximum benefit of the exercise in “training” your bladder - which involves urinating on a regular schedule, frequently at first, then gradually lengthening the time between bathroom trips. Also relaxation exercises can help maximize the training benefits. Another therapy that women with OAB should discuss with their doctor is vaginal electrical stimulation.