Urge Urinary Incontinence: Causes, Diagnosis, Symptoms, and Treatment

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Urge Urinary Incontinence 

'People with OAB have an urgent, "gotta go" feeling that they can't control.' 

common bladder problem is called Overactive Bladder (OAB), or Urgency Urinary Incontinence (UUI). If you feel a strong urge to urinate even when your bladder isn't full, your incontinence might be related to overactive bladder, sometimes called urge incontinence. This condition occurs in both men and women and involves an overwhelming urge to urinate immediately, frequently followed by loss of urine before you can reach a bathroom. Even if you never have an accident, urgency and urinary frequency can interfere with work and a social life because of the need to keep running to the bathroom.

Causes & Diagnosis of Urge Incontinence or Overactive Bladder

    1. Infection of the bladder
    2. Inflammation of the bladder
    3. Bladder stones 
    4. Prostate enlargement in men
    5. Obstruction in bladder opening
    6. Bladder cancer
    7. Nervous system disorder
    8. Many times no specific reason is identified
The frequent urge to urinate happens when the bladder muscle, also known as the detrusor, begins to contract and signals a need to pee even when the bladder is not full. Another name for this phenomenon is detrusor overactivity. Overactive bladder can result from physical problems that keep your body from stopping involuntary bladder muscle contractions. Such problems include damage to the brain, the spine, or the nerves extending from the spine to the bladder — for example, from an accident, diabetes, or neurological disease. Irritating substances within the bladder, such as those produced during an infection, might also cause the bladder muscle to contract.
A condition called myofascial pelvic pain syndrome has been identified with symptoms that include overactive bladder accompanied by pain in the pelvic area or a sense of aching, heaviness, or burning. In addition, infections of the urinary tract, bladder, or prostate can cause temporary urgency. Partial blockage of the urinary tract by a bladder stone, a tumor (rarely), or, in men, an enlarged prostate (a condition known as benign prostatic hyperplasia, or BPH) can cause urgency, frequency, and sometimes urge incontinence. Surgery for prostate cancer or BPH can trigger symptoms of overactive bladder and radiation seed treatment (brachytherapy) for prostate cancer. Neurological diseases (such as Parkinson's disease and multiple sclerosis) can also result in urge incontinence, as can a stroke. When hospitalized following a stroke, 40% to 60% of patients have incontinence; by the time they are discharged, 25% still have it. 

Tests of bladder function 

In some cases, your doctor might order tests to assess how well your bladder, urethra and sphincter are functioning (urodynamic tests). Bladder function tests may include:

Measurements of post-void residual urine

If there's concern about your ability to empty your bladder completely, particularly if you are older or have had prior bladder surgery or have diabetes, then this test can tell how well your bladder is functioning. A specialist uses an ultrasound scan, which translates sound waves into an image, to view how much urine is left in your bladder after you urinate. In some cases, a thin tube (catheter) is passed through the urethra and into your bladder. The catheter drains the remaining urine, which can then be measured.

Measuring bladder pressures - Cystometry

Cystometry is a test that measures pressure in your bladder and in the surrounding region as your bladder fills. Your doctor may recommend this test to check for stress incontinence if you have had a neurologic disease of the spinal cord. A catheter is used to fill your bladder slowly with warm fluid. As your bladder fills, you may be asked to cough or bear down to test for leaks. This procedure may be combined with a pressure-flow study, which tells how much pressure your bladder has to exert in order to empty completely.

 Creating images of the bladder as it functions - Urodynamics

Video urodynamics is a test that uses imaging to create pictures of your bladder as it's filling and emptying. Warm fluid mixed with a dye that shows up on X-rays is gradually instilled in your bladder by a catheter while the images are recorded. When your bladder is full, the imaging continues as you urinate to empty your bladder.

Cystoscopy

This test uses a scope that is inserted into the bladder to look for blockages or any abnormalities in the bladder and urethra. This procedure is usually completed in the office.

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