When you have a bladder control problem, you may find it difficult to talk about your symptoms. Many people who are now getting treatment for their bladder control problems also used to feel shy, ashamed, or embarrassed about their condition. But they took the first step and talked to their healthcare providers. Now many of them are receiving treatment and are on their way to a better quality of life.

The symptoms of overactive bladder:

  • Urinary frequency – often having to go to the bathroom more than 8 times in 24 hours
  • Frequency at night (nocturia) may include waking up to urinate 2 or more times at night
  • Urgency – a strong and sudden desire to urinate
  • Accidental loss of urine associated with a simultaneous sudden and controllable urge to urinate (urge incontinence)

Overactive bladder can be treated by your family doctor or, if you are a woman, you can discuss your symptoms with a gynecologist. In some cases, your family doctor or gynecologist may refer you to a specialist, such as a urologist or urogynecologist – a doctor who specializes in bladder and urine control problems.

Before you make an appointment to see your doctor:

To help get ready to talk to a doctor about a bladder control problem, you should be prepared to talk about your symptoms and your medical history. It may be helpful to keep a diary in which you write down how much you drink each day, how often you go to the bathroom, and the amount urinated each time. You may also consider filling in the screening questionnaire at the end of this article. Bringing your diary and the completed questionnaire to the doctor’s office will help you talk about your symptoms.

When you call to make an appointment, be sure to say that you would like to discuss a bladder control problem. Or, if you are already seeing your doctor for another reason, don’t wait until the end of the appointment to bring up your symptoms. The doctor will need time to evaluate your symptoms and find out if they are related to another condition.

Make a list of any prescription or over-the-counter medicines that you are taking, and bring the list with you to your appointment. Women who have had children will need to discuss their pregnancy and childbirth experiences.

At the doctor’s office:

After the doctor has asked you questions and reviewed any written information that you provided, you may undergo a physical exam. In addition, the doctor may want to perform some simple tests to help find the reason for your problem.

Urinalysis is one of the most commonly used tests for the evaluation of bladder control problems. It involves the in-depth examination of a urine sample, which is analyzed to determine whether your symptoms are caused by overactive bladder or another problem, such as a urinary tract infection.

If further tests are needed, a family doctor or gynecologist may refer you to a urologist. Such tests are only performed when the doctor feels that more information is required to confirm or clarify a diagnosis. One of these tests, called cystoscopy involves the use of a thin telescope, to allow the doctor to see the inside of the bladder to check for tumors or stones, which can mimic the symptoms of the overactive bladder. In addition, the doctor may perform urodynamic testing, which helps to assess several aspects of bladder function, including whether the bladder and sphincter muscles are functioning properly; whether you have normal bladder sensations and sufficient bladder capacity (the ability to hold an appropriate amount of urine); and whether your bladder fills and empties normally. An x-ray test called a cystogram may also be used to examine how the position of the bladder and urethra changes during normal urinating, coughing, or straining.

Your doctor can explain how each of the test results will be used. The results may help determine whether you have a bladder control problem or some other condition (such as a urinary tract infection) and can help identify the type of bladder control problem you may have. After the test results have been analyzed, the doctor will be able to give you a diagnosis and will then describe your treatment options.

If your doctor prescribes medication for your bladder control problem, there are a few important things you should know before the end of your appointment.

  • What medication will you be taking?
  • How often should you take the medication?
  • How long do you need to take the medication?
  • What side effects may occur?
  • When do you need to come in for a follow-up visit?

Remember – nearly everyone with a bladder control problem can be helped, so schedule your appointment soon!

For more information on overactive bladder, visit:

American Foundation for Urologic Disease
http://www.afud.org/oab/

American Medical Women’s Association – Overactive Bladder Initiative
http://www.amwa-doc.org/Education/ overactive_bladder.htm

National Association for Continence
http://www.nafc.org

National Kidney and Urologic Diseases Information Clearinghouse
http://www.niddk.nih.gov/health/urolog

Pharmacia & Upjohn – Overactivebladder.com
http://www.overactivebladder.com

The Simon Foundation for Continence
http://www.simonfoundation.org/html/index.html

WellnessWeb – Access to Continence Care and Treatment
http://www.wellweb.com/INCONT/urinacct.htm

Eric S. Rovner M.D.

Author