Managing Overactive Bladders in Men

For most men, one trip to the bathroom will empty the bladder and provide relief for several hours. Men with overactive bladder (OAB) will regularly feel a powerful urge to urinate throughout the day and night. OAB can be life-altering, affect men of all ages, and wreak havoc on your job, social and active lifestyle, and your sleep. Thankfully, there are a variety of approaches available to ease an overactive bladder and get your life back.

Many of the symptoms of OAB may interfere with your day-to-day activities. You may experience:

• Urinary urgency: This is an intense sensation to urinate, which may be difficult to stop or ignore.
• Urge incontinence: This is an involuntary loss of urine following a strong urge to urinate. Some people may leak small amounts of urine, while others may experience an unintentional loss of a large volume of urine.
• Urinary frequency: Feeling the urge to urinate more than eight times in a 24-hour period.
• Nocturia: This term describes the need to get up two or more times during the night to use the toilet.
• Pelvic pain: A 2008 study explains the inflammatory proteins, known as cytokines, may be responsible for causing pain in the pelvis or bladder and producing some of the symptoms of OAB.
• Incomplete voiding: Some people may have difficulty emptying their bladders. This can lead to an overactive bladder because the bladder reaches its full capacity quickly and needs to be relieved more often.

While an overactive bladder may be viewed as a woman’s issue, a 2009 study states, “The prevalence of overactive bladder (OAB) symptoms is considerable in both men and women, and the impact on quality of life (QOL) is equally substantial.”

As mentioned earlier, a primary cause of OAB in men may be due to an enlarged prostate. As stated by the National Association of Continence (NAFC), about half of all men will experience an enlarged prostate by age 60—the number goes up to 90 percent by age 85. The enlarged prostate hinders the flow of urine, requiring extra trips to the bathroom.

There are other causes of OAB as well. Neurological conditions such as strokes, Parkinson’s disease, and spinal cord injuries may be responsible. Plus, other medical conditions like diabetes, frequent urinary tract infections, or chronic constipation, can be potential causes. Additionally, structural abnormalities of the bladder and declining cognition may influence symptoms.

Note that these are potential causes—it doesn't mean that your OAB is caused by any or some of these issues. An open conversation with your doctor will help relieve any concern you have and bring you appropriate treatment.

There are multiple treatment approaches available to help you manage OAB and decrease its effects on your daily life. The National Institute of Diabetes and Digestive and Kidney Diseases Health (NIDDK) provides a comprehensive list of treatment approaches. They include:

• Bladder training: For this treatment approach, your doctor will probably refer you to a pelvic health specialist or physical therapist. These are professionals with specialized training in bladder, bowel, and sexual health. Bernadette Kamin, a physical therapist at Kamin Physical Therapy in Illinois, says, “There are effective physical therapy treatment options for men with OAB. Men should not have to live with bladder symptoms that significantly affect their lifestyle. For more information on what physical therapy can do for men with OAB, contact the American Physical Therapy Association, an organization that has sections specializing in male and female pelvic floor dysfunction.”
• Drug therapies: There are a variety of medications such as Tolterodine, Oxybutynin, and Solifenacin that relax the bladder. Common side effects of these drugs include dry eyes and dry mouth.
• Neuromodulation: NIDDK states, “Mild electrical pulses can be used to stimulate the nerves that control the bladder and sphincter muscles.” The pulses can be delivered to a variety of locations, including through the tailbone or on specific sites on the skin. There is a range of neuromodulation devices, from conservative approaches to the surgical implantation of a permanent nerve stimulator.
• Injections into the bladder: In small doses, Botox injections may provide short-term relief in people who have severe urge incontinence. To remain effective, the injections have to be administered from time to time. Discuss potential side effects with your doctor.
• Surgery: Typically, surgery is a last resort when previous treatment options haven’t been successful. Surgical interventions may be used to increase the bladder’s capacity to hold urine, or, in unrelenting circumstances, the removal of the bladder may be considered.

The signs and symptoms of an overactive bladder can be disruptive to your life, but the sooner you discuss these symptoms with your doctor, the quicker you can be on the road to finding relief, managing the condition, and getting your life back. Please know not all treatments will work right off the bat. It may take a few attempts to find the appropriate combination of interventions to best help you.