Hyperactive bladder in women: treatment, causes, symptoms

A hyperactive bladder in women, the treatment of which is required immediately after the problem is detected, is a disruption of the urine accumulation function and the sudden urge to empty the bladder. This need is often acute and leads to the involuntary release of a certain amount of urine (incontinence).

Traditionally, therapy begins with the use of behavioral (strategy) strategies - doctors recommend drinking water and other drinks strictly on schedule, visiting the toilet every day at a certain time and restrain sudden desires with the help of the pelvic floor muscles. If these measures do not help, there are other methods of treating pathology.

Symptoms

If you have trouble urinating, it's not a fact that they are caused by a hyperactive bladder. Symptoms in women are as follows:

• The sudden need to visit the toilet, and this need is extremely difficult to control;
• Urinary incontinence, that is, her involuntary release immediately after the urge to empty the bladder;
• Frequent urination, usually more than eight times a day;
• Night polyuria (nocturia) - night urge to go to the toilet, repeating more than two times during sleep.

Although many patients manage to reach the toilet immediately, as soon as an acute need arises, almost everyone suffering from this pathology experiences stress from the urge to empty the bladder many times a day.

Normal functioning of the body

The kidneys produce urine, which then flows into the bladder. When you visit the lavatory, urine leaves the storage organ through the hole below and flows outward through a tube called "urethra". In women, the hole of the urethra is located directly above the vagina, in men - at the tip of the glans penis.

As the bladder is filling, the brain receives signals from the nerves, which, in the end, cause the need to empty. When urinating, the nerve signals coordinate the relaxation of the pelvic floor muscles and the urethra (the latter are called the urinary sphincter muscles). The muscles of the organ tense (contract), pushing the urine out.

Causes of pathology

When the muscles of the body begin to suddenly strain (even if the volume of urine in it is still small), doctors diagnose a hyperactive bladder. Symptoms in women include, first of all, a sharp emergence of need and may be accompanied by signs of diseases that serve as prerequisites for the development of this ailment. However, chronic diseases are not the only cause of the problem. At the heart of frequent walking to the toilet and incontinence may lie:

• Neurological disorders, including Parkinson's disease, strokes, multiple sclerosis;
• Intensive urine production as a result of consumption of large volumes of fluid, unsatisfactory functioning of the kidneys or diabetes;
• Taking medications that accelerate the production of urine or require swallowing a large amount of fluid;
• Acute infectious diseases of the urethra, causing symptoms similar to those of a disease such as a hyperactive bladder in women;
• Organ pathology (tumors, stones);
• Factors that prevent normal urination (in men this may be an enlarged prostate, in women - constipation or past operations in order to treat other forms of incontinence);
• Excessive intake of caffeine or alcoholic beverages;
• Oppression of cognitive function of the brain due to aging of the body, as a result of which the bladder hardly recognizes incoming signals;
• Difficulties in walking, because of which not all patients can reach the latrine in time;
• Incomplete emptying of the bladder, which can lead to symptoms of hyperactivity due to a decrease in free space for new urine coming from the kidneys.

Often, however, even specialists can not say exactly what caused the development of the syndrome of body hyperactivity.

Diagnostics

If you suffer from the unbearable need to visit the toilet too often, the doctor will first check your urine for blood or infection. You also need to determine if you empty the bladder completely. A complete diagnosis is likely to include the following activities:

• Study of the history of diseases;
• Primary medical examination with special attention to the organs of the abdominal cavity and groin;
• Urinalysis for testing for infections, traces of blood and other signs of pathology;
• Focused neurologic examination to detect abnormalities in sensory perception or reflex problems.

Special researches

First, the doctor will establish an accurate diagnosis and presumptive prerequisites for the development of such an unpleasant condition as a hyperactive bladder in women. Treatment will depend on many factors, but primarily on the quality of the functioning of the body. The ability of the bladder to regularly and completely empty is checked by the urodynamic method, which consists of several different analyzes.

What is included in the concept of urodynamic analysis

• Measurement of residual volume of urine. This analysis is especially important if the body is not emptied entirely with urination, or if you suffer from incontinence. Residual urine causes symptoms similar to those of hyperactivity. To measure the remainder of the liquid after emptying, the doctor will prescribe an ultrasound examination of the bladder or will put a special catheter (a thin tube) to withdraw and examine the residue.
• Measurement of the flow rate of urine. If you need to assess the volume and speed of urination, the doctor will ask you to empty the bladder in a uroflowmeter - an instrument that measures these parameters and converts them into a graph of changes in the rate of emptying.
• Determination of intravesical pressure. The method of cystometry helps to measure pressure in the organ and surrounding tissues when it is filled with liquid. During this study, the doctor uses a thin tube (catheter) to slowly fill the bladder with warm water. Another catheter with a sensor that is sensitive to changes in pressure is placed in the vagina. This procedure helps to understand why a hyperactive bladder occurs in women. Treatment will depend on what the analysis will show: either involuntary contractions of the organ walls or its rigidity will be observed, as a result of which the bladder becomes unable to store urine at low pressure. You may be asked to empty during the study to measure the pressure needed to empty the organ and clarify the presence or absence of possible blockage (obstruction). Obstruction due to prolapse of the pelvic organs can lead to the symptomatology typical of such a widespread ailment as a hyperactive bladder in women. Causes (treatment, as is known, can only appoint a qualified specialist) in this case almost always include neurological diseases affecting the spinal cord.

Treatment by behavioral therapy

Behavioral therapy, or the acquisition of useful habits necessary to combat an ailment, is the first and most effective measure on the road to recovery. The undoubted advantage of this method is the complete absence of side effects. If you have no idea how to treat a hyperactive bladder in women, try the techniques listed below.

The best methods to solve the problem

• Exercises for the muscles of the pelvic floor. Kegel's exercises have not only gained worldwide fame and unprecedented popularity: perhaps there is no more natural way to strengthen the muscles of the pelvic floor and urinary sphincter. Stronger muscles can permanently rid you of involuntary contractions of the walls of the bladder. The doctor will give detailed advice on the proper performance of the famous gymnastics. Follow the recommendations of a professional and be patient: for a noticeable improvement in well-being it often takes quite a long time (six to eight weeks).
• Maintaining a normal weight. If you are suffering from obesity, a return to normal weight will help to tame the hyperactive bladder in women. Treatment (reviews can be found on thematic forums if desired) in this case implies compliance with a diet based on the principles of proper nutrition.
• Control of fluid intake. The doctor may recommend limiting the use of fluids and helping to make a convenient schedule for drinking your favorite drinks.
• Double emptying. To make the bladder completely emptied, you need to wait a couple of minutes after the first emptying and then try again to fix a small need.
• Planned urination. The method of the schedule is useful not only in the sense of using liquids, but also for visiting the toilet. If you follow the planned schedule (for example, go to the toilet every 2-4 hours), then the body will get used to the same regime, and you will cease to feel unnecessary stress from suddenly rolling need.

What else can you do?

• Periodic catheterization. When a hyperactive bladder is diagnosed in women, treatment and feedback about the prescribed therapy will largely depend on the individual effectiveness of the prescribed method. However, there is a common, universal way to alleviate the symptoms of pathology, which involves the periodic use of a catheter to completely empty the organ. Consult with your doctor before using this method.
• Wearing urological pads. Use of urological pads or special absorbent underwear will help protect clothing from the effects of incontinence and eliminate the associated psychological stress. Such pads and linen come in all sizes and have different rates of absorbency.
• Bladder training. By this term is meant the development of one's own ability to restrain a small need. You need to start from small periods - for example, from 30 minutes, after which you can gradually increase the intervals until you go to the toilet only once every three to four hours. The hyperactive bladder in women (treatment, causes, symptoms discussed above) is possible to stabilize in this way only if you are able to independently contract (contract) the muscles of the pelvic floor.

Hyperactive bladder in women: treatment (medication)

To reduce the syndrome of hyperactivity, medicines are used that help to relax the walls of the organ. It:

• Tolterodine ("Detroil");
• Oxybutynin in the form of a cutaneous (transdermal) patch ("Oxytrol");
• Oxybutynin in the form of a gel ;
• Trospium;
• Solifenacin;
• Darifenacin;
• Fesoterodine.

Be careful

The above medicines can cause side effects, including dry mouth and constipation, which can aggravate the symptoms of a disease such as a hyperactive bladder in women. Treatment (tablets and other drugs for oral administration) should be prescribed by a doctor, but if you suffer from these side effects, it is better to consult with a specialist about the replacement of tablets for gels and patches.