9 Complications of Overactive Bladder (OAB)

What is an Overactive Bladder?

An overactive bladder refers to a range of symptoms related to the urinary system. The most common symptom it causes is a frequent and urgent urge to urinate that might not be easy to control.(1, 2) A person experiencing an overactive bladder is likely to feel like they need to pass urine frequently and many times during the day, as well as at night. They may also experience urine incontinence or an unintentional loss of urine. In most cases, having an overactive bladder refers to the feeling of ‘needing to go’ to the bathroom urgently and often. Having an overactive bladder is likely to make you feel embarrassed, disrupt your routine, cause you to isolate yourself, or limit your social and work life.(3, 4, 5)

It is estimated that nearly 30 percent of men and 40 percent of women in the United States experience overactive bladder.(6) Many people having this condition often avoid seeking treatment as they feel embarrassed. In fact, many people either are not aware of how to discuss such symptoms with their doctor, or they think that there are no treatments for helping their symptoms. Many even consider these symptoms to be a normal part of getting older or caused by something they did.(7)

9 Complications of Overactive Bladder (OAB)

An overactive bladder is very much treatable, but finding the correct treatment might take some time. In the meantime, you continue to live with the complications caused by an overactive bladder.

Some of these complications are described below:

  1. Overactive Bladder Affects Your Quality of Life

    The symptoms of an overactive bladder affect a person’s quality of life significantly. These symptoms and the coping strategies that one has to come up with to manage the symptoms can disrupt the normal routines at home, work, and in any social setting. This may include having to interrupt a meeting or conversation to rush out to the bathroom. It also affects your choice of places to visit as you always need to ensure there is a restroom nearby.(8, 9)

    An overactive bladder is likely to make you feel disruptive, rude, and inconsiderate of others, but you don’t have any choice in the matter. It may ultimately lead to situations where you start planning your outings around your condition.(10)

  2. Productivity Goes Down

    Frequent urination along with urinary urgency means that you are going to be sleep deprived. This can cause chronic fatigue to set in, which is likely to interfere with your work and day-to-day chores. Overactive bladder is also going to reduce your productivity at home and at work because you have to keep interrupting whatever you are doing to use the bathroom frequently.(11)

  3. Negative Impact On Sex Life

    Studies and surveys have shown that having an overactive bladder can have a dramatically negative impact on your sex life.(12) Many people with overactive bladder, especially young women, try to avoid having sexual intercourse out of fear that they may have urine leakage during intercourse. Furthermore, interrupting your sex session to run to the bathroom to pee is definitely going to disrupt sexual satisfaction for both partners, and neither is it attractive to have to make a dash for the bathroom like this in the middle of sex. Since urinary issues and the sexual organs are so closely linked, an overactive bladder is sometimes also known to affect overall sexual functioning.(13, 14)

  4. Fatigue

    Nocturia, or the excessive urge to urinate at night, is a common symptom in people with overactive bladder. This symptom involves you having to get out of bed two or three times, or sometimes more, at night to urinate. This is a big cause of chronic fatigue since you are not able to get a night of proper restful sleep. The lack of energy that sets in is likely only to worsen the other complications of an overactive bladder. Every time you need to urinate in the night, you wake up and then struggle to get back to the deep and most restful stages of sleep. This leads to chronic fatigue over a period of time.(15, 16, 17)

  5. Avoidance of Social Interactions

    People living with an overactive bladder often start to avoid leaving their house out of fear that they will have a flare-up of their symptoms or fear what people will think if they keep rushing to the bathroom. Urge incontinence, or the sudden urge to urinate, is difficult to control, and you need to be at a place with a restroom. This often causes people to miss out on fun or important events that are considered to be an essential part of a healthy lifestyle for anyone. If you are someone who once enjoyed attending many social events, this avoidance of social interactions is likely to affect you even more than those who are introverts by nature. You are likely to feel more isolated and remain housebound out of discomfort, embarrassment, and fear of urge incontinence.(18)

  6. Dehydration

    There is a common misconception that people with an overactive bladder can avoid urinary incontinence if they restrict their fluid intake. In contrast to this, avoiding sufficient drinking of fluids can cause great distress to the bladder and even worsen the symptoms of an overactive bladder. In severe cases, it might even lead to dehydration. Your doctor will help you strike the right balance between staying hydrated and worsening of your symptoms.(19, 20)

  7. Depression

    Having an overactive bladder impacts your quality of life quite severely. Having a lower quality of life is likely to have an emotional impact on people with overactive bladder. The discomfort, lack of restful sleep, self-imposed isolation, and the constant need to use the restroom can restrict healthy relationships and, over time, lead to depression. According to studies, there is a strong link between the symptoms of overactive bladder and depression.(21, 22)

  8. Infections

    If the underlying cause of your overactive bladder is an infection, then leaving it untreated can lead to more complications. Failure to treat urinary tract infections (UTIs) can cause bladder infections, which further increases the risk of having more urinary tract infections in the future.(23, 24)

  9. Increased Risk of Recurrent Falls and Fractures

    Studies have shown that the urgency and incontinence associated with overactive bladder dramatically increases the risk of having recurrent falls and fractures, especially in older adults.(25) It has also been found that the risk of falling and the fear of falling increase in people with overactive bladder. This is mainly because people with this condition are more likely to rush to use the restroom.

What is the Treatment for Overactive Bladder?

There are several treatment options available for addressing overactive bladder in people. Some of these include:

  • Herbs and supplements such as magnesium hydroxide.
  • Making dietary changes, including avoiding tomato-based foods, caffeinated beverages, citrus fruits, and other irritants.
  • Doing exercises like bladder training and Kegel exercises.
  • Botox injections
  • Oral medications like tolterodine (brand name Detrol, Detrol LA) and oxybutynin (brand name Ditropan XL).
  • Using the patch.
  • Different types of surgery, including bladder removal or nerve stimulation.

Conclusion

An overactive bladder refers to a combination of urinary symptoms that include a frequent urge to urinate, waking up at night to urinate, and urine leakage, amongst others. The symptoms of an overactive bladder can be a cause of considerable stress and have a negative impact on the quality of life. It may even lead to depression. It is best to talk to your doctor about your symptoms. An overactive bladder can be treated, but it may take time to find the right treatment. Your doctor will be able to determine what is the best treatment for you.

References:

  1. Ouslander, J.G., 2004. Management of overactive bladder. New England Journal of Medicine, 350(8), pp.786-799.
  2. Stewart, W., Van Rooyen, J., Cundiff, G., Abrams, P., Herzog, A., Corey, R., Hunt, T. and Wein, A., 2003. Prevalence and burden of overactive bladder in the United States. World journal of urology, 20(6), pp.327-336.
  3. Wein, A.J. and Rovner, E.S., 2002. Definition and epidemiology of overactive bladder. Urology, 60(5), pp.7-12.
  4. Milsom, I., Stewart, W. and Thuroff, J., 2000. The prevalence of overactive bladder. Am J Manag Care, 6(11 Suppl), pp.S565-73.
  5. Wein, A.J. and Rackley, R.R., 2006. Overactive bladder: a better understanding of pathophysiology, diagnosis and management. The Journal of urology, 175(3S), pp.S5-S10.
  6. Urologyhealth.org. 2021. Overactive Bladder (OAB): Symptoms, Diagnosis & Treatment – Urology Care Foundation. [online] Available at: <https://www.urologyhealth.org/urology-a-z/o/overactive-bladder-(oab)> [Accessed 16 October 2021].
  7. Steers, W.D., 2002. Pathophysiology of overactive bladder and urge urinary incontinence. Reviews in urology, 4(Suppl 4), p.S7.
  8. Abrams, P., Kelleher, C.J., Kerr, L.A. and Rogers, R.G., 2000. Overactive bladder significantly affects quality of life. Am J Manag Care, 6(11 Suppl), pp.S580-S590.
  9. Chiaffarino, F., Parazzini, F., Lavezzari, M. and Giambanco, V., 2003. Impact of urinary incontinence and overactive bladder on quality of life. European urology, 43(5), pp.535-538.
  10. Jackson, S., 1997. The patient with an overactive bladder—symptoms and quality-of-life issues. Urology, 50(6), pp.18-22.
  11. Coyne, K.S., Sexton, C.C., Kopp, Z.S., Ebel‐Bitoun, C., Milsom, I. and Chapple, C., 2011. The impact of overactive bladder on mental health, work productivity and health‐related quality of life in the UK and Sweden: results from EpiLUTS. BJU international, 108(9), pp.1459-1471.
  12. Coyne, K.S., Sexton, C.C., Thompson, C., Kopp, Z.S., Milsom, I. and Kaplan, S.A., 2011. The impact of OAB on sexual health in men and women: results from EpiLUTS. The journal of sexual medicine, 8(6), pp.1603-1615.
  13. Coyne, K.S., Margolis, M.K., Jumadilova, Z., Bavendam, T., Mueller, E. and Rogers, R., 2007. OUTCOMES ASSESSMENT: Overactive Bladder and Women’s Sexual Health: What is the Impact?. The journal of sexual medicine, 4(3), pp.656-666.
  14. Sand, P.K., Goldberg, R.P., Dmochowski, R.R., McIlwain, M. and Dahl, N.V., 2006. The impact of the overactive bladder syndrome on sexual function: a preliminary report from the Multicenter Assessment of Transdermal Therapy in Overactive Bladder with Oxybutynin trial. American journal of obstetrics and gynecology, 195(6), pp.1730-1735. Weiss, J.P. and Blaivas, J.G., 2002. Nocturnal polyuria versus overactive bladder in nocturia. Urology, 60(5), pp.28-32.
  15. Ge, T.J., Vetter, J. and Lai, H.H., 2017. Sleep disturbance and fatigue are associated with more severe urinary incontinence and overactive bladder symptoms. Urology, 109, pp.67-73.
  16. Shokouhi, N., Saedi, N., Mohseni, M., Feizabad, E., Saeedi, S. and Miri Ashtiani, E., 2021. Sleep Quality and Fatigue in Women with Overactive Bladder: A Case-Control Study. Shiraz E-Medical Journal, (In Press).
  17. Irwin, D.E., Milsom, I., Kopp, Z., Abrams, P. and Cardozo, L., 2006. Impact of overactive bladder symptoms on employment, social interactions and emotional well‐being in six European countries. BJU international, 97(1), pp.96-100.
  18. Wood, L.N., Markowitz, M.A., Parameshwar, P.S., Hannemann, A.J., Ogawa, S.L., Anger, J.T. and Eilber, K.S., 2018. Is it safe to reduce water intake in the overactive bladder population? A systematic review. The Journal of urology, 200(2), pp.375-381.
  19. Callan, L., Thompson, D.L. and Netsch, D., 2015. Does increasing or decreasing the daily intake of water/fluid by adults affect overactive bladder symptoms?. Journal of Wound Ostomy & Continence Nursing, 42(6), pp.614-620.
  20. Melotti, I.G.R., Juliato, C.R.T., Tanaka, M. and Riccetto, C.L.Z., 2018. Severe depression and anxiety in women with overactive bladder. Neurourology and urodynamics, 37(1), pp.223-228.
  21. Lai, H.H., Shen, B., Rawal, A. and Vetter, J., 2016. The relationship between depression and overactive bladder/urinary incontinence symptoms in the clinical OAB population. BMC urology, 16(1), pp.1-8.
  22. Wagner, T.H., Hu, T.W., Bentkover, J., LeBlanc, K., Stewart, W., Corey, R., Zhou, Z. and Hunt, T., 2002. Health-related consequences of overactive bladder. American Journal of Managed Care, 8(19; SUPP), pp.S598-S607.
  23. Fitzgerald, M.P., Thom, D.H., Wassel-Fyr, C., Subak, L., Brubaker, L., Van Den Eeden, S.K., Brown, J.S. and Reproductive Risks for Incontinence Study at Kaiser Research Group, 2006. Childhood urinary symptoms predict adult overactive bladder symptoms. The Journal of urology, 175(3), pp.989-993.
  24. Moon, S.J., Kim, Y.T., Lee, T.Y., Moon, H., Kim, M.J., Kim, S.A. and Choi, B.Y., 2011. The influence of an overactive bladder on falling: a study of females aged 40 and older in the community. International neurourology journal, 15(1), p.41.