The most common symptom experienced by people with overactive bladder, or OAB, is the uncontrollable urge to urinate. This may lead to accident or leaks.
Sometimes related symptoms show up. These can include:
- difficulty to start urinating
- having to strain or force urine to come out
- having a weak or split urine stream
People with OAB also complain of having to go to the bathroom many times during the day, and may wake up frequently during the night to urinate.
Causes of overactive bladder in men
Between 11 and 16 percent of men experience OAB, and the symptoms are more likely to appear with age.
One of the more common causes of OAB symptoms in men is the prostate getting larger. The prostate may simply get larger as men age, or may be a sign of a serious growth or prostate cancer. If the prostate grows enough, it can disrupt the flow of urine out of the urethra.
Symptoms of OAB in men have many other causes though, including:
- weak muscles near the bladder
- urinary tract or bladder infections
- bladder stones
- uncontrolled diabetes
- mobility issues
- taking certain medications
- neurological conditions, like Parkinson’s disease and multiple sclerosis
Symptoms of OAB can affect every aspect of a person’s life. People may find the disorder embarrassing, which can lead to them not seeking medical advice or solutions to the symptoms.
Luckily, the symptoms of OAB can often be treated in one or more promising ways.
The first step in any treatment method is to be diagnosed by a qualified doctor.
The doctor will take a brief history about a person’s urinary tract health and any medical conditions or procedures they have had. Then a physical examination will be done.
Generally, these exams include:
- a rectal exam to determine prostate health
- neurological exam
- sphincter exam
The doctor will also likely take a urine sample to analyze. They may ask questions about urinary habits, and may ask the patient to empty their bladder while being monitored on an ultrasound.
All of these methods are designed to figure out the exact cause of overactive bladder in order to correct it. From here, the next step may involve a number of treatment methods.
Many people with overactive bladder find relief from symptoms through changing their diet and making some lifestyle choices.
While this will not solve all cases, it is seen as an important first step in treatment. Lifestyle changes should be made along with other treatments to help ensure success.
There are certain foods and drinks that can make symptoms of OAB worse. Removing these foods and drinks from a person’s diet, may help them support the treatment of these symptoms.
Reducing or eliminating caffeine and alcohol helps some people. Both substances are diuretics, meaning they cause the body to create more urine. This can simply add to the cycle of frequent urination.
Other things to limit when treating symptoms of OAB include:
- carbonated beverages
- aspartame and artificial sweeteners
- cranberry juice, which is another diuretic
As well as limiting certain foods and drinks, cutting down on liquids consumed before bed can help reduce nighttime symptoms.
In addition, spicy foods and acidic foods like orange juice and tomato sauce can irritate the bladder and urethra on their way out. This may make symptoms worse in some patients.
An especially important factor for people with OAB is to make sure they are getting enough water.
Many patients with OAB automatically reduce how much liquid they drink to try and reduce their urine production, which does not actually help.
Reducing fluid intake can cause dehydration and makes urine more concentrated. Concentrated urine irritates the bladder, which can OAB make symptoms worse.
Tobacco use is also associated with OAB symptoms in both men and women. Reducing or eliminating smoking is seen as a positive change towards better bladder health.
Pelvic floor exercises may also be helpful for some patients. During pelvic floor exercises, the patient tightens, holds, and then relaxes the muscles used to urinate.
To find the correct muscles, people can practice the exercise just after urinating. This helps as the memory of which muscle controls urination is fresh.
It is better to practice pelvic floor exercises after the bladder is already empty to ensure there are no leaks or accidents.
Doctors may also advise bladder training to help relieve symptoms like frequent urination.
The urge to urinate is caused by the bladder contracting. In people with OAB, this happens before the bladder is actually full, and leads to many unnecessary trips to the bathroom.
Bladder training is the process of resisting the urge to urinate in order to train the bladder to actually fill up before giving in to the urge.
Bladder training is done slowly. A person usually begins by resisting the urge to urinate for just a few minutes. They can then gradually increase the time up to an hour or more in between bathroom breaks.
Obesity is a direct risk factor for OAB symptoms. Excess weight puts pressure on the bladder and urethra, and may make symptoms worse in many cases.
Controlling weight is a direct way to help with symptoms of overactive bladder. This puts less pressure put on the bladder and urinary tract as the weight reduces.
Weight loss is considered a first line treatment for most overweight people who have symptoms of OAB.
There are also a number of medical treatment options for OAB in men, in the form of prescription drugs.
In cases of OAB caused by an enlarged prostate, doctors usually recommend alpha-blockers. These help relax the surrounding muscles and improve the flow of urine through the urethra.
A 5-alpha reductase inhibitors may also be prescribed. This helps to reduce the size of the prostate over time. Drugs that help reduce spasms in the bladder, or reduce the urge to urinate as much, may also help with certain symptoms of OAB. These drugs include:
For some people, these drugs produce the desired results with little side effects. Others still feel as though they have the symptoms of OAB while on the drugs, or they may not reduce these symptoms enough.
Some people taking these drugs are also intolerant of their side effects, which can range from mild to more severe.
It is important for doctors to be certain of the cause of the symptoms before prescribing medications. The use of the drugs should be heavily monitored, and any side effects should be discussed with a doctor.
There are some cases of OAB that can be helped by nerve stimulation.
Nerve stimulation involves putting a small electrode under the skin. Mild electrical currents are sent to the muscles involved in urination in the pelvis and lower back.
Research suggests that nerve stimulation is effective. It may be recommended as an early form of treatment in cases where people:
- do not respond well to medication
- are awaiting surgery
- do not want surgery
For people who find lifestyle changes, medication, and nerve stimulation are not working, doctors may consider surgery.
The surgeries involve correcting problems with the prostate, bladder, and urethra. This may include:
- correcting the position of the urethra
- relieving pressure on the urethra caused by extra weight
- correcting the position of the bladder
In cases of enlarged prostate, sometimes a piece of the gland may be removed. Surgery tends to be seen as a last resort, or for special cases.
Symptoms of OAB can be common, especially as men get older. It is important not to feel embarrassed and to have a truthful talk with a doctor in order to be properly diagnosed.
While there are many reasons for OAB symptoms, the outlook is good in most situations. Working directly with a doctor, many men find relief from their overactive bladder.
Written by Jon Johnson
Reviewed by Suzsanne Falck, MD, FACP