Overactive Bladder in Men – When you gotta go, you gotta go!


That’s a slogan near and dear to millions of American women and men. A discussion of overactive bladder (OAB) is usually associated with women. However, men can be affected with this incapacitating condition. This article will define OAB, discuss the diagnosis and the management of this common condition.

Overactive bladder can be described as frequent urination, a constant urge to urinate, bladder leaks and nighttime urination. Nearly 33 million Americans live with overactive bladder and 30% of the patients are men.

Symptoms of overactive bladder in men include an urgent need to urinate, frequent urination (more than eight times a day), nighttime urination and a strong urge to urinate, which can lead to urinary incontinence or bladder leakage.

For men, overactive bladder is often secondary to an enlarged prostate. As men age, the prostate increases in size and thus pinches or obstructs the flow of urine and leads to other symptoms such as overactive bladder.

Other causes of OAB in men include urinary tract infection, bladder stones or bladder cancer. Fluid intake, medications and constipation can all be temporary causes for overactive bladder in men.

Diagnosis of OAB
If you are experiencing symptoms of OAB, your doctor will want to take a history of your problem and give you a thorough physical exam. You will also likely need to have your urine tested to look for signs of infection or stones. Your doctor may also give you any of several available tests that evaluate the functioning of your bladder. These include measuring how much urine is left in your bladder after going to the bathroom, measuring the rate of flow when you urinate and measuring the pressure in and around your bladder. Based on test results, your doctor can give you a diagnosis and discuss your treatment options.

Treating OAB
The first type of treatment your doctor will likely recommend is making healthy lifestyle changes. This could involve changing what you eat and drink, keeping a urination record and sticking to a bathroom schedule and maintaining a healthy weight. You may also try a bladder training routine, which aims to help you learn how to delay urinating when you feel the urge to go. Urinating “by the clock” is also a treatment option where men with OAB learn to urinate at a given time, instead of waiting until the bladder gives a signal to urinate and then it is too late when the bladder contracts without its owner’s permission.

Medications to Treat OAB
When lifestyle changes are ineffective at controlling the symptoms of OAB, your doctor may have you try medications. For men whose OAB is caused by an enlarged prostate, a class of drugs called alpha blockers help to relax the surrounding muscles to reduce urine blockage.

Other drugs that may help treat the symptoms of OAB include those that reduce the uncontrolled contractions of the bladder. These medications work to reduce the urge to go, and there are several different drugs that can be used.

Surgery for OAB
If the symptoms of your OAB are severe and other treatments are not effective, your doctor may suggest surgery. If your OAB is caused by an enlarged prostate, a urologist can remove part of the gland or relieve the blockage to pull back the obstruction. This procedure has a high success rate.

Bottom Line: Overactive bladder is not just a problem that impacts women. Men are also affected. Help is available, and nearly everyone, man or woman, with OAB can achieve relief from visiting the restroom so many times a day or night.

Dr. Neil Baum is a physician at Touro Infirmary. He can be reached at (504) 891-8454 or via his website, http://www.neilbaum.com

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