Guest Author - Denise Howard, M.D., M.P.H.

Do you know the location of every bathroom in the mall? Are you constantly going to the bathroom to void? Do you experience a sudden powerful urge to urinate as soon as you put the key in your front door or right when you get to the bathroom?

If you answered yes to any of these questions then you are 1 of the 30 million people who suffer from a condition called “Overactive Bladder”. Overactive bladder (OAB) is a syndrome that includes the symptoms of urinary frequency, urgency and sometimes urge incontinence. It is normal to void 7-8 times during the day and get up no more than twice after going to sleep at night. Urinating more than this is considered to be abnormal. Urgency is the sudden compelling desire to void that can not be ignored. For some women this is associated with urinary leakage (or wetting themselves); this is urge incontinence.

Any of these symptoms can be disruptive, embarrassing and even expensive. Professionally, going to the bathroom may disrupt your productivity at work, possibly even jeopardizing your job. The constant need to go to the bathroom may interfere with social activities leading to isolation and depression. For others urinary incontinence or fear of leakage can interfere with sexual relations contributing to marital strife. Unexpected leaking or wetting episodes can be quite embarrassing leading to constant bathroom trips, decreased social activities and even the adoption of wearing protective undergarments. Incontinence pads can become quite expensive.

These problems are not an expected part of aging and treatments are available. Primary care physicians and gynecologists are capable of initiating an evaluation of these problems. If the treatment is not straight forward then they may elect to refer you to a specialist. Sometimes the above symptoms maybe a sign of more serious problems such as an infection, pelvic prolapse, or a malignancy. It is, therefore, crucial to mention these problems to your provider, so that a thorough evaluation is started.

Once it is determined that overactive bladder is the problem, then appropriate treatment can be initiated. The treatment options include medications, bladder retraining, avoidance of dietary irritants, pelvic floor muscle rehabilitation with a physical therapist, or minimally invasive surgical therapies. As mentioned earlier, your primary care physician can perform the initial evaluation; however, referral to a specialist, such as an Urogynecologist or an Urologist will be warranted in many situations.