Overactive Bladder: Managing Frequent Urination and Anxiety

Q: Overactive Bladder: Managing Frequent Urination and Anxiety

Hello： If there are so many hospitals conducting examinations and all items are complete with no issues, there should be no problems with the urinary organs. <br>However, during the consultation period, medication should have been prescribed, which usually has a noticeable effect

I recommend that you wear a diaper?

Hello, doctor.
Recently, I started experiencing frequent urination, going to the bathroom 8-10 times a night, and I had severe pain in my urinary tract that made me roll in bed.
I visited Fu Jen Catholic University Hospital, where the doctor diagnosed me with a urinary tract infection and suggested I wear adult diapers.
However, later it was determined that there was no infection, and I was diagnosed with overactive bladder, possibly due to the upcoming exams.

After that, I experienced frequent urination again, averaging many trips to the bathroom over 2-3 days, with one instance of going twice within a minute, which was very distressing.
I then visited the urology clinic next to National Taiwan University, where the doctor assessed my urinary function and stated that the urodynamics were normal.
He diagnosed me with autonomic nervous system dysfunction.

A few days later, I went to Taipei Tzu Chi Hospital for a consultation, where the doctor advised against wearing adult diapers and suggested I measure my total urine flow.
However, halfway through the measurement, I ended up urinating over 20-30 times in one day, and I was running out of space on my tracking sheet.
The doctor said it was up to me to decide whether to wear adult diapers.
That day, I urgently wore a diaper overnight, but I ended up urinating dozens of times in it.
I then returned to Tzu Chi Hospital to see a psychiatrist, who indicated that I had autonomic nervous system dysfunction and endocrine imbalance, and prescribed medication to alleviate my stress symptoms.
A few days later, I was tested for bladder capacity, and the urologist said everything was fine, so I stopped going for further consultations.
However, the next day, I began to feel slight itching and pain in my urethra and bladder, along with urgency.
Even today, after drinking a little water, I feel the urge to urinate within 10 minutes, but I only pass a small amount.
It seems that I urinate as much as I drink, and even without drinking, the urge to urinate quickly overwhelms my bladder and urethra.

I would like to ask the doctor how I should handle this situation.
I am unsure if it is a psychological issue or if there is an underlying condition.
Thank you very much, and I wish you a lifetime of peace and well-being.

Huli Shixusheng, 30~39 year old female. Ask Date: 2024/06/05

Dr. Du Shixi reply Urology

Hello: If there are so many hospitals conducting examinations and all items are complete with no issues, there should be no problems with the urinary organs.
However, during the consultation period, medication should have been prescribed, which usually has a noticeable effect.
If there is no effect, consider whether there have been any other physiological changes, and it may be necessary to consult a psychiatrist to see if there is a need for management.
As for diapers, they can be used when symptoms are prominent.
Wishing you good health.

Reply Date: 2024/06/05

More Info

Overactive bladder (OAB) is a condition characterized by a frequent and urgent need to urinate, often accompanied by discomfort or pain. Your experience of frequent urination, especially at night, along with the associated pain, can be distressing and significantly impact your quality of life. It is understandable that you are seeking clarity and management strategies for your symptoms.

From your description, it appears that you have undergone various evaluations, including urine tests and bladder function assessments, which have ruled out urinary tract infections (UTIs) and indicated that your bladder function is normal. This is a positive sign, as it suggests that there may not be any structural abnormalities in your urinary tract. However, the diagnosis of overactive bladder and the mention of autonomic nervous system dysregulation indicate that your symptoms may be multifactorial, involving both physiological and psychological components.

The frequent urge to urinate, especially when you are anxious or under stress (such as during exam periods), can be exacerbated by anxiety. Anxiety can lead to increased sympathetic nervous system activity, which may heighten the sensation of urgency and discomfort in the bladder. This is often referred to as "nervous bladder," where psychological stress manifests as physical symptoms.
Here are some strategies that may help you manage your symptoms:
1. Behavioral Techniques:
- Bladder Training: This involves gradually increasing the time between urinations to help your bladder hold more urine. Start by delaying urination for a few minutes when you feel the urge, and gradually extend this time.

- Scheduled Voiding: Set specific times to use the bathroom, regardless of the urge. This can help train your bladder and reduce the frequency of urgent urges.

2. Pelvic Floor Exercises: Strengthening the pelvic floor muscles can improve bladder control. Kegel exercises, which involve contracting and relaxing the pelvic muscles, can be beneficial.

3. Dietary Modifications: Certain foods and beverages can irritate the bladder. Consider reducing caffeine, alcohol, and spicy foods, and increase your water intake to help dilute your urine.

4. Stress Management: Since anxiety seems to play a role in your symptoms, incorporating stress-reduction techniques such as mindfulness, meditation, or yoga can be helpful. Cognitive-behavioral therapy (CBT) may also be beneficial in addressing anxiety and its impact on your bladder symptoms.

5. Medication: If your symptoms persist, discuss with your healthcare provider the possibility of medications specifically designed to manage overactive bladder. These can help reduce urgency and frequency.

6. Follow-Up Care: Since you have seen multiple specialists, it may be helpful to have a coordinated care approach. Consider consulting a urologist who specializes in overactive bladder or a pelvic floor specialist who can provide targeted therapies.

7. Keep a Symptom Diary: Documenting your fluid intake, urination patterns, and any associated symptoms can provide valuable information for your healthcare provider and help tailor your treatment plan.

It is important to communicate openly with your healthcare providers about your symptoms and any concerns you have regarding medications or treatment plans. If you continue to experience significant distress or if your symptoms worsen, seeking further evaluation from a mental health professional may also be beneficial.

In conclusion, managing overactive bladder involves a combination of behavioral strategies, lifestyle modifications, and possibly medication. Addressing the psychological aspects of your symptoms is equally important, as anxiety can exacerbate physical symptoms. With a comprehensive approach, you can work towards improving your bladder health and overall well-being.

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