There are several causes of an Overactive bladder which have been discussed below:

• Pelvic muscles are the muscles which provide support to the organs of your lower abdomen. During pregnancy or after childbirth, these pelvic muscles and tissues become weak from stretching. Weak pelvic muscles dislocate the bladder from its normal position, causing urine leakage.
• Certain medicines make the nerves dull, which sends the wrong signals to the brain and causes the bladder to overflow. Alcohol and caffeine can also lead to an overactive bladder or even urgency incontinence.
• Infections like a urinary tract infection (UTI) can adversely affect the nerves of the bladder. This can make the bladder squeeze itself without giving a warning. This may lead to uncontrolled urination.
• Excess body weight can excessively pressure the bladder, which can cause overactive bladder. .
• Sometimes, certain diseases or sudden trauma can send wrong signals to the brain to urinate without warning. Parkinson’s disease, herniated disk, stroke, pelvic and back surgery, radiation and multiple sclerosis can cause the brain to receive wrong signals.
• A deficiency of the hormone estrogen after menopause can lead to an overactive bladder.
• Diabetes can be a cause of Overactive bladder.
• Tumours and bladder stones can put pressure on the bladder and cause urine leakage.
• Constipation, certain surgeries and enlarged prostate can obstruct the normal flow of urine. This can lead to an Overactive bladder.

If you are suffering from Overactive bladder, you may experience the following symptoms:

• ● The sudden urge to urinate, which may be uncontrollable
• ● A condition called urgency incontinence where you may have an unintentional and uncontrolled loss of urine immediately after you feel the need to urinate. Urgency incontinence differs from stress urinary incontinence where patients can urinate while trying to laugh, sneeze or do other day-to-day activities
• ● Frequent urination where you may need to urinate for over eight times a day. In some patients, the frequency may increase
• ● The need to urinate more than twice in the middle of the night, which will disturb your sleep (nocturia)
• ● Bedwetting
• ● Bladder spasm

If you cannot control your urge to urinate, your doctor will carry out several tests to check whether you are suffering from an infection or you have blood in your urine. Your doctor will advise the following tests:

• Measuring urine left in the bladder: Your doctor will conduct this test if you feel you cannot empty your bladder after urinating. They will perform an ultrasound of your bladder to check the amount of urine left in the bladder after you urinate. In certain cases, a catheter is used to drain out the excess urine from the bladder.
• Measuring urine flow rate: A uroflowmeter is a device that is used to measure the speed and volume of urination. An Uroflowmeter measurs the flow of urine and then translates the data in a graph.
• Testing bladder pressure: To measure your bladder pressure, your doctor will conduct cystometry. Your doctor will use a catheter and fill your bladder with a warm liquid. With the help of another catheter, it will place a pressure measuring sensor in the rectum. The sensor will tell how much pressure your bladder would need to empty.

Your doctor will use a combination of treatments to control your Overactive bladder disease.

• Behavioural therapies: Behavioural therapies are the first treatment procedure your doctor uses to treat overactive bladder. Behavioural interventions include pelvic floor muscle exercises, biofeedback, maintaining a healthy weight, scheduling your toilet trips, using a catheter at regular interventions to empty the bladder, and wearing absorbent pads and bladder training.
• Medicines: Vaginal estrogen therapy can help strengthen the muscles of the vaginal area in menopausal women. It is available in various forms such as creams, tablets, rings, or suppository.

Your doctor can also prescribe certain medicines that help in bladder control such as Trospium, Tolterodine, Solifenacin, Fesoterodine, Darifenacin, Mirabegron and Oxybutynin. Some medicines could cause side effects such as dry mouth, but it can be treated by drinking lots of water.

• Nerve Stimulation: nerve stimulation can help treat symptoms of an Overactive bladder. Your doctor may place a thin wire close to your sacral nerves. The thin wires will send signals to your bladder. Your doctor then uses a hand-held device to send electrical signals to your bladder.

If the procedure is proved to be helpful, then your doctor will surgically place a permanent pulse generator to regulate the flow of urine.

• Bladder injections: A protein called OnabotulinumtoxinA can be helpful to treat an overactive bladder if injected directly into the tissues of the bladder in small doses.
• Surgery: Your doctor will suggest a surgery to treat an overactive bladder if you do not respond to other combinations of treatment. There are two surgeries, one to increase the capacity of the bladder and the other to remove the bladder and replace it with a neo-bladder.

An Overactive bladder can irritate your lifestyle and day to day activities. But you should not be demoralised and go for treatment as soon as possible. You should drink the prescribed amount of water and eliminate food items that can aggravate symptoms of uncontrolled urination.

With proper medication and a healthy lifestyle, you can cope up with your Overactive bladder symptoms.