Many things can play a role in causing your bladder to be overactive. Overactive bladder is urgency—strong, sudden urges to urinate—usually with frequency and nighttime urination. Some people also experience leakage of urine. To get relief, your doctor must figure out what is triggering the urges. Your doctor will use various means to do that. Here is what you can expect when you see your doctor about overactive bladder.
The first step is a physical examination, which may provide clues about what's causing your symptoms. For women, overactive bladder may involve problems with the organs in the pelvis. For men, the problem may involve the prostate. Your doctor will also check your reflexes.
Your doctor will look for such things as:
Bladder prolapse—dropping or sagging
Nerve damage from diabetes, an infection, or another medical condition
Vaginal prolapse
During the exam, the doctor will also ask about your symptoms and any medicine that you take. Tell your doctor about any recent injuries or surgeries. Also describe any health problems you have now or had in the past.
To get more details about your bladder problem, your doctor may ask you to keep a bladder diary. You will record how you feel, how often you go to the bathroom, and if you ever leak urine. You will also keep track of what you drink and when. A bladder diary can reveal patterns in your symptoms over the course of several days. This will help your doctor figure out what is going on and what tests you may need.
Urinary tract infections, other infections, and some drugs can cause overactive bladder symptoms. Testing a urine sample—urinalysis—can help your doctor rule out infection, urinary stones, or another health problem as the cause of your condition.
Cystoscopy is a procedure that lets the doctor check the inside of your bladder. A thin tube with a light and tiny camera is inserted through the urethra—the tube that lets urine flow out of the body. Your doctor will use local anesthesia so you will not feel anything. The procedure takes only 10 to 15 minutes. Cystoscopy can help find tumors, blockages, or problems with the lining of the bladder.
Urodynamics are a series of tests. They show how well the bladder, the muscles that control the release of urine, and the urethra are working. Urodynamic tests check the bladder’s ability to hold urine and empty completely. They also can show if the bladder is contracting involuntarily, which can cause urine to leak. Your doctor may record how long it takes you to start urinating. The doctor also may measure how much urine you produce. Other tests measure the pressure inside the bladder, as well as muscle and nerve activity.Examples of urodynamic tests include:
Cystometric test measures the amount of urine the bladder can hold, how much pressure builds up in the bladder as it fills with urine, and how full the bladder is once you feel the urge to urinate.
Postvoid residual measurement shows the amount of urine left in the bladder after urination.
Uroflowmetry checks urine speed and volume.
Doctors may use ultrasound when diagnosing overactive bladder. This test uses sound waves to create an image of the kidneys, ureters, bladder and urethra. It can show how much urine is in the bladder and how well the bladder is emptying. The doctor also can get good information from ultrasound about the lining of the bladder and the size of the prostate. It also can help detect bladder stones and tumors.
