If you find yourself waking up frequently at night, having trouble sleeping, rushing to the bathroom every time, and just as you're about to relax, the familiar urge to urinate forces you to stand up. You feel restless, tired, and even worried about whether your bladder is functioning badly. This "uninvited guest" who constantly bothers you may be overactive bladder.
Ms. Wang, 65, wakes up at 5:30 a.m. every morning and has to get up again every hour or so to go to the toilet. Even though she tries to avoid drinking water during the day, she still urins frequently. She recalls: "I always wake up at night, I can't sleep soundly, and I always want to run to the toilet during the day, which is too torturous." "After the doctor's diagnosis, it was found that she was suffering from the typical overactive bladder.
This problem is very common and affects many middle-aged and older people around the world, especially women. Symptoms include urinary urgency, frequency, nocturia, and may even be accompanied by urinary incontinence, which greatly affects quality of life. Many patients are afraid to leave the house for fear that they may have an urgent need or leakage at any time, and the scope of their lives is shrinking. To solve this problem, we need to understand the causes and diagnosis methods of overactive bladder before we can effectively formulate a solution.
Causes and diagnosis of overactive bladder
The causes of overactive bladder are varied and may be related to bladder muscle dysfunction, neurological abnormalities, or other factors. The main reasons include:
Abnormal activity of the bladder muscles: The detrusor muscles of the bladder wall are responsible for emptying the bladder. But in overactive bladder, this muscle can contract abnormally even when the bladder isn't full, causing urgency and frequency.
Neurological problems: Damage to the central nervous system can detrusor muscles, and common neurological disorders include multiple sclerosis, spinal cord injury, and Parkinson's disease.
Hormonal changes: Menopausal women are prone to genitourinary atrophy due to decreased estrogen levels, resulting in abnormal bladder function.
Other factors: Some surgical procedures, obesity, urinary tract infections or tumors, abnormal glucose metabolism, psychological stress, etc. may also induce overactive bladder.
Diagnostic process
A correct diagnosis of overactive bladder is essential to develop a treatment plan. Doctors usually make a diagnosis by:
Detailed history: patients should describe the frequency of urination, urgency, nocturia, and possible symptoms of urinary incontinence. You will also be asked about a history of other urinary disorders or surgeries.
Voiding diary: Keeping track of the time and amount of urine you urinate each time can help your doctor understand your urination pattern and identify what is wrong.
Laboratory tests: routine urine testing can rule out urinary tract infections or other urinary disorders. Blood tests can help check for underlying factors such as abnormal glucose metabolism.
Bladder function tests: including urodynamic studies and bladder manometry, can help assess the functional status of the detrusor muscles of the bladder and rule out bladder problems due to neurological disorders.
Imaging tests: ultrasound and cystoscopy can rule out tumors or other organic lesions in the bladder.
Once the diagnosis is confirmed, doctors can develop an individualized treatment plan based on the cause, including medications, behavioral rehabilitation, or a combination of the two, to help people return to a normal quality of life.
Medication: Prescribe the right medicine
Drug treatment strategies for overactive bladder include anticholinergics and beta3-adrenergic agonists, which can relieve symptoms and improve patients' quality of life. However, treatment needs to be tailored to the individual condition, used with caution, and closely monitored for response.
Anticholinergic drugs
These drugs inhibit excessive contraction of the detrusor muscle by blocking the binding of acetylcholine to the Bladder's M3 receptors, thereby reducing symptoms of urgency and frequency. Commonly used anticholinergic drugs include oxybutynin, tolterodine, and solifenacin, among others. Although effective, it may cause side effects such as dry mouth, constipation, and blurred vision, especially in older patients.
β3-肾上腺素能受体激动剂
These drugs relax the detrusor muscle by activating the beta3 receptors of the bladder detrusor muscle, thereby increasing the bladder's urinary storage capacity and reducing urinary urgency and frequency. The representative drug is mirabegron. It has mild side effects and is suitable for patients who cannot tolerate anticholinergic drugs. However, indicators such as the cardiovascular system also need to be monitored regularly to ensure that the medication is safe.
Adjuvant medications
Some adjunctive medications, such as local anesthetics, botanicals, and antidepressants, are also used to treat overactive bladder. Herbal treatments can be used as a supplement, but they need to be used under the guidance of a doctor to ensure efficacy and safety.
Medication is not a panacea, and patients need to work closely with their doctor to choose the type of medication that is right for them, pay close attention to side effects, and adjust the dose or change the medication if necessary. By combining scientific rehabilitation training, the effect of drug treatment will be more significant.
Rehabilitation training: scientific exercise to restore bladder function
Rehabilitation training for overactive bladder can enhance the patient's ability to control the bladder and reduce the symptoms of urinary urgency and frequency. Scientific training methods include bladder training, Kegel exercises and lifestyle modification to provide patients with a comprehensive management plan.
Bladder training
The capacity of the bladder is gradually increased by lengthening the interval between urination. Initially, the interval can be extended by 10 to 15 minutes at a time, with the goal of lengthening to urinate every 3 to 4 hours. This process requires the patient to keep a voiding diary to gradually increase the tolerance of the bladder. Bladder training requires patience and sustained effort, but is effective in relieving urinary urgency and nocturia.
Kegel exercises
This exercise is designed to strengthen the pelvic floor muscles and help the patient better control urination. Patients need to find the right muscles and tighten and relax them regularly. To do this, hold the tightening for 3 seconds, then relax for 3 seconds, and do it 10 times in a row. Do 3 sets a day and gradually increase the duration to 10 seconds. Avoid holding your breath or tightening your abs during training to avoid affecting the effect.
Lifestyle modifications
Lifestyle changes can also have a positive impact on bladder control. Reduce your intake of substances that irritate your bladder, such as caffeine, alcohol, and carbonated drinks. Quitting smoking, controlling fluid intake, maintaining weight, and increasing moderate exercise can all help.
Comprehensive application
A combination of rehabilitation and medication can be effective in improving symptoms. An individualized training plan should be developed in conjunction with the physician and reviewed regularly to monitor the effectiveness of the training and adjust the strategy as appropriate.
Through the combination of scientific medication and rehabilitation training, patients with overactive bladder can achieve significant symptom relief and return to normal quality of life.