00:04My name is Dr. Reona Tantarla. I am a full-time urologist at Bajo International Hospital.
00:14So I would start by defining what an overactive bladder syndrome is. So it is one of the common
00:23clinical conditions characterized by a group of urinary symptoms which include the first
00:31one is urgency. Urgency meaning it is a sudden strong desire to urinate that is difficult
00:39to postpone. So that the patient usually rush to the toilet whenever they feel the bladder
00:46is full and there is a fear of incontinence. So the other symptoms are also increased
00:54the urinary frequency during the daytime, during the night time, and some of the patients might
01:01have incontinence as well. This condition is, as I said, it is common. It affects both men
01:08and women, but it is relatively more common in women. And incidents also increase with
01:18aging, especially at the age of the 40. And in the postmenopausal women, urgency with incontinence.
01:26So strong desire to urinate, which is accompanied or followed by urinal incontinence. It is more
01:33common in females. And it has a very negative impact on the quality of life. Like it will
01:41affect the sleep, it will cause sleep, the Easter ones, because there is increased frequency in the
01:48night time. It affects the sexual function. It will cause anxiety and the depression. It even sometimes
01:56cause social isolation because of the incontinence that they have. So it affects both men and women,
02:05but relatively more common in women populations. Usually the cause is idiopathic, meaning the specific
02:12cause is not known. But in some population, they will have underlying neurologic disease like stroke,
02:20Parkinson's disease and different spinal cord disorders, including spinal cord injury. But
02:28the other risk factors are like aging. So as the age increases, especially after the age of the 40,
02:35the incidence will increase. And incidence is also higher in those population who have diabetes
02:44diabetes. And those who have pelvic floor muscle weakness. Also taking excessive caffeine and alcohol
02:52increase incidence of this syndrome. With age, after the age of the 40, the incidence is around 20 to 30
03:01%
03:02in men and around 30 up to 40% in the women. So especially overactive bladder with incontinence is more
03:12common in men. So it is more common in old age and especially in the post-menopausal women. And also
03:26men who have
03:28the bladder outlet obstruction, diabetes patients. Before that, let me discuss how can we diagnose this disease.
03:38So this is the symptoms that I said, like the urgency, increased frequency in the daytime, the nighttime,
03:47and also urgent continence are not specific for this syndrome. There are also multiple other diseases
03:54that cause this symptom. So before we diagnose this syndrome, we should rule out other possible causes,
04:01which include urinary tract infections, different bladder conditions like a bladder cancer, the bladder
04:09stone. Also in men, we should rule out the bladder outlet obstruction, especially secondary to the enlarged
04:16prostate. So we should rule out other causes before we diagnose this thing. We also ask the patient
04:23to keep their bladder diary, meaning they should record the amount and the type of the fluid they take
04:30and the urine amount, also the frequency and the absence or the presence of urgency and incontinence.
04:40So they will record these things. It's called the bladder diary. It helps us for the diagnosis
04:45and they may need a urine test to rule out the urinary tract infection, also other causes. They may need
04:53abdominal imaging. And some of the patients might need cystoscopic examination just to see the urethra
05:01and the bladder with a camera. And very few patients might need advanced investigation, like a
05:08urodynamic test. And so when we come to how to treat this condition, the first thing is a lifestyle
05:20modification. As I said, one of the risk factor is taking excessive caffeine and alcohol. So the patients
05:27are advised to reduce the caffeine, soft the drinks, sweet the drinks, and also foods which have high
05:35spices. These things should be reduced. In addition, there are some pelvic floor muscle exercises,
05:43like Kegels exercise that helps them to reduce the frequency as well as the urgency. And the second line
05:51management is the medication. There are certain medications that reduce the urgency and the frequency.
05:58And very few patients might need advanced intervention if the lifestyle modification and
06:05the medication has failed. But these are very few groups of patients. As I've said, the first line is
06:14behavioral therapy and lifestyle modifications. So to reduce caffeine, sugar, and spicy food, also the soft
06:25drinks. And also there is what is known as bladder training. We advise the patient to avoid at specific
06:35time intervals, which will increase time intervals, which will be increased over time, so that they can
06:39train their bladder to hold urine for longer period of time. And other is pelvic floor muscle exercise, which can
06:49be shown by the physiotherapist. Once the physiotherapist shows them how to do the pelvic floor muscle exercise
06:56in the proper way, then the patient can do it at their home. It doesn't need special things. The second
07:03line is
07:03medication. There are specific medications to treat these diseases. And most of the patients will respond
07:13for this for lifestyle modification plus medication. And very few patients might need advanced.
07:20Most patients like the more than 80 percent of the patients will respond for this lifestyle modification
07:28and behavioral and the medication. But the condition is a chronic condition. And the objective of the
07:37treatment is not to cure, rather to control the symptoms so that the patient will have better
07:45quality of life. As I said, this disease affects the quality of life of the patient,
08:07long-term follow-up and stepwise treatment. So when the patient has these symptoms, like urgency,
08:18incontinence, and with or without the increased frequency of the urination, they need to visit their
08:28primary physician. And if it needs a referral, they can be referred to the urologist. And the main thing
08:35is we should rule out other serious diseases before we diagnose this disease, because those symptoms are
08:42not specific for overactive, for overactive, for overactive bladder syndrome, because there are also other
08:49serious diseases that can cause the symptoms like bladder cancer, bladder stone, and the bladder outlet
08:57obstructions. So this thing should be ruled out by the urologist. So once we are sure the diagnosis is
09:04overactive overactive. So those simple lifestyle modifications, they can control the symptoms,
09:13and if the symptoms still persist, they despite the lifestyle modification, and the doctor will give
09:19them some drugs that are very, very effective. So I advise them to visit a physician for the proper diagnosis
09:31and the proper treatment.
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