Overactive Bladder vs. Urinary Incontinence

When it comes to bladder health, few conditions can be as disruptive as overactive bladder and urinary incontinence. On the surface, these issues may seem similar - after all, both involve uncontrolled bladder leakage. However, they stem from very different causes and require tailored treatment plans. This article will dive deep into understanding the distinctions between overactive bladder and incontinence.

What is an Overactive Bladder?

The urge to empty the bladder that is abrupt, frequent, and usually difficult to control is the hallmark of an overactive bladder (OAB). Even though their bladders may not be full, people with OAB may feel as though they need to go to the bathroom all the time. In a 24-hour period, they would need to urinate eight or more times. Even when the bladder is not full, involuntary bladder contractions can produce overflowing bladder syndrome (OAB). Signals from the nerves controlling the bladder cause the contractions. A number of factors can lead to OAB:

Damage or changes to the bladder muscles or nerves that control the bladder
Blockage from an enlarged prostate gland, pregnancy, constipation, or tumors
Infection, bladder stones, or bladder cancer
Neurological disorders like stroke, multiple sclerosis, or Parkinson's disease

Those with severe OAB may need to wear absorbent products like adult diapers to manage potential leakage and accidents. Women are more likely to develop OAB, with as many as 30 percent of men and 40 percent of women in the United States living with OAB symptoms. The high number of women compared to men could be potentially due to pregnancy and childbirth or hormonal changes during menopause. Advancing age also increases OAB risk for both men and women.

What are the Symptoms of an Overactive Bladder?

The primary symptom of OAB is a sudden urge to urinate that is difficult to control. Other OAB symptoms include:

Urgency - feeling a strong, intense need to urinate immediately
Frequency - needing to urinate more than eight times in 24 hours
Nocturia - waking up multiple times at night to use the bathroom
Urge incontinence - leakage of the bladder when urgency hits

People with OAB may need to use the bathroom many times during the day and night. They may feel like they can never empty their bladder. The constant urination can disrupt sleep, work, and everyday activities. Leakage and incontinence can be embarrassing and difficult to manage.

What is Urinary Incontinence?

Urinary incontinence refers to any uncontrolled leakage of the bladder. It results when the muscles that control urination weaken, or the bladder does not function properly. There are several types of urinary incontinence:

Stress incontinence - leakage with coughing, sneezing, exercise or movement
Urge incontinence - leakage due to OAB-related bladder spasms
Overflow incontinence - leakage from a bladder that does not empty fully
Functional incontinence - leakage due to factors like mobility issues or medication side effects
Mixed incontinence - a combination of more than one type of leakage

Urinary incontinence is more common among older adults but can occur at any age. This might necessitate the use of pull-ons to manage the incontinence. Women experience incontinence more often due to factors like pregnancy, childbirth, and menopause. Other risk factors include obesity, family history, and pelvic surgery.

What Causes Urinary Incontinence?

There are various causes of urinary incontinence, including:

Weakened Pelvic Floor Muscles - Childbirth, surgery, aging, and obesity can damage and weaken the pelvic floor muscles that support the bladder and urethra. This can lead to stress and urgency incontinence.
Bladder Changes - The bladder may become stiff and less elastic, reducing its storage capacity. It may contract involuntarily due to nerve signals or bladder irritation.
Overflow Incontinence - When the bladder does not empty properly, it overflows, resulting in leakage. This can be due to a blockage or nerve damage.
Conditions Affecting Bladder Control - Diabetes, strokes, UTIs, Parkinson's disease, and multiple sclerosis can impact nerves that control the bladder or urethral sphincter.
Constipation - Chronic straining can weaken pelvic floor muscles over time. Hard stool in the rectum can also pressure the bladder, causing urgency and leakage.

What are the Symptoms of Urinary Incontinence?

Symptoms depend on the type of incontinence but may include:

Leaking bladder when coughing, sneezing, laughing, or doing exercise
Sudden, intense urge to urinate followed by leakage
Frequent urination, waking at night to use the bathroom
Inability to fully empty the bladder
Dribbling

Mild urinary incontinence may happen occasionally with triggering actions like exercise. More severe cases can result in leaks throughout the day and frequent bathroom trips. The constant risk of embarrassment and skin irritation can significantly affect quality of life.