The Relationship Between Overactive Bladder and Incontinence

The frequent urge to urinate and its associated symptoms are common problems for many Americans. It often occurs with age, although other factors can contribute to urinary problems in younger people, as well.

Two of the most common complaints people have as they age are overactive bladder, which is a medical condition, and urinary incontinence, which is a symptom. While these issues are often related, they have some subtle differences that are important to understand as you work with your doctor on diagnosis and treatment.

What is an overactive bladder?

Overactive bladder or OAB is characterized by a strong and urgent need to pee, even at times when your bladder isn’t full. This can be persistent and interrupt day-to-day functions such as work, family outings, and more. According to the National Library of Medicine, it occurs more frequently in women than men, with 43% of women and 27% of men in a large survey responding that they experience urinary urgency “sometimes.”

People with OAB may experience this urgency at varying times of the day and night and have to urinate several times in 24 hours. You may also experience a loss of bladder control and urine leakage, which is a symptom known as incontinence. This is where the overlap and confusion between OAB and incontinence tend to occur, as incontinence is a common symptom of OAB.

“It is common that people with overactive bladder also have urge incontinence, meaning when they have the urgency to urinate, they cannot control it, and they leak,” says Raveen Syan, M.D., a urologist with the Desai Sethi Urology Institute at the University of Miami Health System. “However, overactive bladder is characterized by urinary urgency, with or without incontinence.”

What is incontinence?

While OAB is a medical condition, Dr. Syan emphasizes that urinary incontinence is a symptom that can accompany different conditions, including OAB.

The National Library of Medicine recognizes the following types of incontinence:

• Urge incontinence. This accompanies a strong urge to urinate and is the type most frequently seen with overactive bladder.
• Overflow incontinence. This occurs when your bladder doesn’t fully empty and leaks as it fills back up. It’s more common in men.
• Functional incontinence. This occurs along with physical or mental disabilities such as Alzheimer’s disease.
• Transient incontinence. This is a temporary form of incontinence due to circumstances such as a new medication or an infection. It tends to go away over time.
• Mixed incontinence. When incontinence is due to more than one factor, it’s known as mixed.

This is a common issue in young children but can also occur in adults with certain medical conditions or when taking some medications.

Stress urinary incontinence is when leakage occurs due to sneezing, coughing, heavy lifting, and other forms of exertion.

“Stress urinary incontinence is due to poor support of the urethra (the tube through which you pee urine from the bladder). This is most common among women and can be more common in women with vaginal childbirth and/or advanced age,” says Dr. Syan.

“Stress urinary incontinence is the loss of urine when there is a Valsalva maneuver (coughing, laughing, jumping, sneezing) where the abdomen pushes down on the bladder and, because of a lack of support to prevent this leakage, the urine leaks out.”

What to do about OAB and incontinence

Regardless of what’s at the root of your issues with urinary urgency or incontinence, it’s worth a visit to your doctor, says Dr. Syan.

“Seeking care should be related to how bothered you are by your symptoms, but any degree of concern, even mild, is a good reason to seek care,” she says.

Prevention and treatment, of course, will vary based on the specific nature of your symptoms or the cause of incontinence.

For an overactive bladder, steps can be helpful. These include:

• Avoid excessive fluid intake
• Maintain regular bathroom habits that avoid holding urine for too long
• Avoid irritants such as caffeine, spicy foods or carbonated beverages

If self-care strategies are not fully effective at managing your OAB, there are also medications and treatments that are helpful, says Dr. Syan.

If stress urinary incontinence is present, pelvic floor exercises such as Kegels or Pilates may help. “People see the greatest benefit when working with a pelvic floor physical therapist, a person who specializes in treating pelvic floor disorders,” says Dr. Syan.

Here again, there are other medical treatments available if self-care strategies alone aren’t effective for managing your incontinence.

Wyatt Myers is a contributor for UHealth’s news service.

Tags: bladder muscles, cough sneeze, Dr. Raveen Syan, treat overactive bladder, urinary retention