HYPERACTIVE BLADDER

Hyperactive bladder syndrome is characterized by a complex of symptoms. The predominant symptoms are urgency and frequent urination. Urge incontinence and nocturia may be accompanying symptoms.

What is urgency?

Urgency is the sudden, irresistible and hard to postpone desire to void.

What is frequent urination?

Frequent urination is present when the patient needs to void more than 8 times in 24 hours.

How common is the hyperactive bladder syndrome?

The incidence of hyperactive bladder in Europe, in people aged 40 years and over, is 15% for men and 17% for women.

However, the number may be larger, given that most women do not mention the problem to their physician, either due to fear or embarrassment, or even because they think that the condition is untreatable.

The incidence of the syndrome increases by age to such an extent, that a lot of people consider the condition as a natural consequence of aging.

Hyperactive bladder syndrome has a negative impact on the patient’s quality of life as it affects:

  • Social life
  • Sleep: some patients wake up two or more times during the night to void and thus they never enjoy a comfortable and restful sleep
  • Sexual activity: a number of sufferers avoid sexual relationships for fear that they will experience urine leakage during intercourse
  • Exercise: some patients avoid participating in sports activities for fear of possible urinary incontinence

How is the hyperactive bladder syndrome diagnosed?

The diagnosis is established by an urologist based on:

  • History
  • Filling out of specialized questionnaires
  • Keeping a voiding diary

In the voiding diary, the patient writes down his fluid intake, frequency of voiding and amount of urine output.

More than 8 urinations over 24 hours, accompanied by urgency and voiding of relatively small amounts of urine, establish the diagnosis of the syndrome.

It is worth mentioning that, at first, other pathological conditions sharing the same set of symptoms must be ruled out (bladder stones, urinary tract infection, bladder cancer, neurogenic bladder).

How is the hyperactive bladder syndrome treated?

  • Lifestyle changes: cutting down on foods and beverages that possibly stimulate the bladder (coffee, chocolate, spicy food, alcohol and sodas)
  • Pelvic floor exercises – bladder retraining program: it refers to an exercise program, aimed at strengthening the pelvic floor muscles which, when vigorously contracting, can stop bladder contraction and prevent incontinence.
  • Medication: there are several available medications which are very effective in the treatment of urge incontinence.

In the few cases where prior treatments have failed, intravesical infusion of special drugs and electric neurostimulation can prove effective.