Overactive Bladder (OAB)

Overactive Bladder, OAB

Overactive bladder (OAB) is a prevalent condition affecting both men and women. People experiencing overactive bladder often feel embarrassed and frustrated especially when their condition has a direct impact on their daily lives. Although common in older adults, it may occur at any age. However, OAB symptoms should not be considered a normal part of aging.

OAB is characterized by a sudden, uncomfortable urge to urinate, with or without urine leakage. These symptoms can occur frequently during the day and at night.  OAB occurs when muscles of the bladder squeeze or contract more often or more strongly than normal. Rather than staying at rest as urine fills the bladder, these muscles tend to contract at inappropriate times, even though the bladder may only contain a small amount of urine.

Filling and emptying of the bladder is a complex interplay of nerve signals, kidney function, and muscle activity. As part of normal bladder function, the kidneys produce urine, which travels to the bladder. One of the major muscles of the bladder is the detrusor. As part of the normal process of urination, the detrusor muscle will contract in response to filling of the bladder with urine. The contraction and relaxation of the detrusor muscle is regulated by the nervous system.  Approximately 300mL of urine in the bladder signals the nerves to trigger the bladder muscles to coordinate urination. Urine is voided by draining from the bottom of the bladder through a short tube called the urethra. Voluntary control of the sphincter muscles at the opening of the bladder can hold the urine in the bladder for longer. Up to 600mL of urine can be contained in a normal adult bladder.  Involuntary loss of urine is referred to as incontinence.

Symptoms of OAB may be triggered by

  • drug side effects;
  • diabetes mellitus, prostate gland enlargement;
  • multiple pregnancies;
  • urinary tract infection, bladder stones, or bladder tumours; or
  • nervous system abnormalities including: 
    • stroke,
    • nerve damage (e.g. spinal cord injury), or
    • neurological diseases (e.g. multiple sclerosis (MS) and Parkinson's disease).

Sometimes there is no apparent or known cause for overactive bladder (often referred to as idiopathic overactive bladder).

Overactive bladder may be treated with drugs, behavioural therapies, and neuromodulation (electrical stimulation of nerves or tissue). Current therapies may be ineffective, have unfavourable side effects, and/or people may experience a combination of both.  As such new and effective ways to treat overactive bladder need to be developed.

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