While overactive bladder (OAB) and urinary incontinence both involve issues with the bladder’s function, the two conditions are not the same. OAB involves issues of urinary urge, while incontinence involves the leakage of urine from the bladder. Let’s look at how these two conditions differ--and what can be done to treat them.
Overactive bladder (sometimes called irritable bladder) disproportionately affects women more than men. OAB can be caused by a neurological condition like multiple sclerosis, but for most people the cause is unknown.
When a person has an overactive bladder, she feels strong, sudden urges to urinate throughout the day. Normally, as a person’s bladder slowly fills with urine, the bladder sends a signal to the brain that it needs to empty itself. This sensation starts out with a mild feeling of needing to empty when the bladder is only partly full. The signal becomes stronger as the bladder fills up. When people have OAB, this signaling process malfunctions. Instead of sending indications of varying intensity, the bladder may only send strong, urgent signals. The reasons for this signaling problem remain unknown but may involve nervous system issues or abnormal muscle contractions in the lower abdomen.
In addition to the increased urgency to urinate, people with overactive bladder experience a higher frequency of urination. People with OAB often urinate more than eight times a day and up to twice at night, while people without the condition empty their bladders much less frequently.
Sometimes a person with OAB experiences urine leakage after a strong urge to void. This leakage is called urinary incontinence, and it isn’t solely a result of overactive bladder.
Many people experience urinary incontinence--the uncontrolled flow of urine from the bladder--especially as they get older. This condition can affect both men and women, though about twice as many women have urinary incontinence as men. Urinary incontinence can result in small or large volumes of urine leakage.
In women, urinary incontinence often is related to weakened pelvic floor muscles due to pregnancy and childbirth. This muscle weakness allows urine to seep from the bladder when a person sneezes, laughs or performs some physical activity that puts stress on muscles in the lower abdomen. This type of urinary incontinence is called “stress incontinence” and is the most common form of the condition.
In men, stress incontinence can occur due to aging or to surgeries on the prostate that affect anatomical structures near the bladder.
Both overactive bladder and urinary incontinence can be treated, though in different ways. To address OAB’s symptoms of urge and frequency of urination, doctors can prescribe medications or administer botulinum toxin injections to calm muscle spasms that might be causing urges to urinate.
Urinary incontinence often can be addressed by strengthening the pelvic floor muscles and making lifestyle changes such as losing weight and limiting caffeine intake. Women with severe cases of urinary incontinence often benefit from bladder sling surgery to provide extra support to pelvic structures.
Both OAB and urinary incontinence can severely affect a person’s quality of life. It can be depressing to constantly cope with strong urges to void and the dampness or odor of frequent urine leakage. Fortunately, the available therapies often improve symptoms and allow those with OAB or incontinence to take control of their bodily functions again.
