Bladder issues not limited to women


Dear Doctor: I’m a 52-year-old man, and I find that lately I have to urinate more often. My doctor says that it’s overactive bladder. I thought that’s something that happens to women. Why am I getting it? My doctor says it’s not because of my prostate.

Dear Reader: It’s true that many types of bladder issues, including overactive bladder, tend to be more common in women than in men. This is attributed to life events that are unique to women, including pregnancy and childbirth, and the hormonal changes that accompany menopause.

But, as you have now experienced, bladder problems occur in men as well. A gender-specific cause of overactive bladder in men does include an enlarged prostate. This can occur because the prostate sits just below the connection point of the bladder and the urethra, which is the tube through which urine exits the body. If the prostate presses against the urethra and impedes the flow of urine, it can lead to irritation that causes the bladder to contract. This can create the need to go, even when only small amounts of urine are present.

Overactive bladder, also referred to as OAB, isn’t a disease in and of itself. Rather, it’s a collection of symptoms related to urinary control. One of the more common signs of overactive bladder is the increased frequency that you have developed. Most people empty their bladders somewhere in the neighborhood of eight times every 24 hours. Another in the group of symptoms is something known as urinary urgency. That’s when, once your body signals the need to urinate, you pretty much have to go right away. When the signal to urinate is accompanied by leakage, that’s known as urge incontinence. And if you’re heading to the bathroom multiple times a night, it’s called nocturia. Someone with one or more of these symptoms is considered to have an overactive bladder.

Elizabeth Ko, MD and Eve Glazier, MD

In both women and men, being overweight, which increases abdominal pressure, can play a role in developing an overactive bladder. So can weak pelvic muscles, which can be caused by pregnancy and childbirth, as well as chronic constipation, coughing, prolonged sitting and aging. Certain medications can contribute to the condition, as can caffeine and alcohol. In some cases, an overactive bladder can be an indication of an underlying problem, such as a urinary tract infection. Neuromuscular diseases, such as multiple sclerosis or Parkinson’s disease, often have an effect on bladder control. Due to nerve placement, a herniated disc or the effects of pelvic of back surgery can also contribute to OAB.

Treatment usually begins with lifestyle changes. This includes reaching and maintaining a healthy weight and doing regular exercises to strengthen the pelvic floor. Your doctor may also discuss bladder training, which is a series of techniques designed to help you learn to delay urination. In more severe cases, nerve stimulation, a range of medications and surgery may be an option. Because the condition can be a sign of bladder stones, nerve damage and even bladder cancer, it’s wise to check with a health care professional if symptoms develop.

(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)