Still Have To Go? You May Have Overactive Bladder
Between 8 percent and 17 percent of American adults—up to 34 million people—suffer from symptoms of overactive bladder: frequent, sudden urges to urinate that disrupt work and sleep and are sometimes accompanied by involuntary urination. Men and women seem to be about equally affected, and the condition is estimated to cost the economy about $12 billion a year in lost productivity, money spent on protective products and treatment costs.
“It’s age-related and wickedly prevalent,” says Dr. Kevin McVary, professor of urology at the Feinberg School of Medicine at Northwestern University. Although men’s symptoms were formerly believed to occur primarily because of an enlarged prostate, researchers now believe that men, too, are affected by urgency and frequency that has little to do with that gland.
McVary and colleagues recently published a study finding that 76 percent of people over 45 diagnosed with the overactive bladder went untreated.
Affected people don’t seek help for many reasons. Some try medication and find it too expensive or the side effects too bothersome; others prefer to deal with it by modifying their lifestyles. “Those are all legitimate reasons,” McVary says. “What’s not OK is saying ‘Oh, I’m getting older and I have to accept wetting and urgency.’ Acceptance only [makes sense] if you know your options and have weighed them.”
Coping with overactive bladder
So how can you best deal with overactive bladder? Most people prefer to start with lifestyle changes. The simplest technique is drinking fewer liquids, particularly in the evening. Not drinking for two hours before bed can sometimes prevent sleep interruption. Caffeine can irritate the bladder for some; in these cases, reducing coffee and cola intake can help.
Exercising can also reduce sudden urges—and for people who are overweight, losing weight can have a big impact. “When they lose weight and keep it off, urination decreases,” McVary says. “And it’s not that fat is pushing down on bladder—it’s not clear why it changes.”
“Bladder retraining” is another technique, usually done with the guidance of a urologist and typically used to reduce episodes of involuntary urination accompanied by sudden urges or by coughing or sneezing. Kegel exercises—yes, those linked with more intense orgasms in women—are one part of the process.
But they aren’t just for women. Men can do Kegels, too. Practice by starting and stopping the flow of urine to locate the correct muscles; don’t use your abs. Then build up to increased time contracting the muscles and increased numbers of repetitions, just like with weight lifting. (No word on whether this improves male orgasm, but it can’t hurt.)
Another aspect of bladder retraining involves gradually learning to wait to urinate when feeling a sudden urge and incrementally increasing the time you can manage comfortably.
“If you start off by trying to hold it for two to three hours, that will be bothersome; it’s not going to work,” says Dr. Matthew Rutman, assistant professor of clinical urology at Columbia University Medical Center, “But if you do it in small increments—for an hour, then an hour and 15 minutes, then an hour and a half, it can help significantly.”
An alternative method puts urination on a schedule. You go at specific times whether you need to or not and gradually become conditioned to the schedule. These methods can take weeks to produce results, and it’s important to track episodes of incontinence and urges to see if they are starting to work.
“That’s a totally legitimate way to try to control it,” McVary says. “I like it because it’s not pushing medications. It’s not clear how successful it is in the long term, but if the person is willing to try, it’s certain something to consider.”