Overactive bladder (GUMP) is a pathological condition characterized by sudden, hard–to-contain urge to urinate, frequent urination, night urination, sometimes accompanied by sudden urge to urinate (in the absence of a urinary tract infection).
Overactive bladder syndrome is not a life-threatening condition, but it significantly affects the quality of life of patients. Interestingly, the prevalence of GPA is the same among men and women.
As a rule, the disease occurs on its own, and it is not associated with other pathologies. Another reason for bladder hyperactivity is neurological diseases such as multiple sclerosis, Parkinson's disease, strokes, herniated discs, and other spinal cord injuries.
Before making a diagnosis of "overactive bladder", first of all, other pathological conditions that cause similar symptoms should be excluded: urinary tract infections, bladder tumors, urolithiasis, pelvic floor muscle dysfunction, diabetes mellitus, neurogenic bladder, interstitial cystitis.
Examination of a patient with symptoms of an overactive bladder must include:
general urinalysis with sediment microscopy;
measurement of the amount of residual urine, especially in patients with neurological diseases and patients after surgery for urinary incontinence;
keeping a urination diary for 72 hours (3 days);
filling out international questionnaires;
cystoscopy is recommended for patients with microhematuria (the presence of blood cells in the urine), suspected bladder tumors, and the presence of foreign bodies;
comprehensive urodynamic examination is especially important in the case of neurogenic urination disorders, as it allows assessing not only the functional state of the lower urinary tract pathways, but also the risk of damaging the kidneys and choosing the most effective treatment;
examination in a gynecological chair (for women) - in order to assess the condition of the pelvic floor muscles, identify pelvic organ prolapse and atrophic changes in the genitals.
An overactive bladder is a chronic, widespread pathological condition that has a significant impact on the quality of life. Fortunately, modern medicine has a large arsenal of treatments for this disease. The treatment of GPA consists of several consecutive steps and is based on the principle of "from simple to complex."
Drug therapy – includes drugs of the anticholinergic group that block muscarinic receptors of the smooth muscle of the bladder. Side effects when taking this group of medications include dryness of the mucous membranes of the mouth, eyes, constipation, and effects on the central nervous system.
Tibial neurostimulation is a treatment method in which the tibial nerve is stimulated with a thin needle electrode anatomically located in the ankle area. The procedure is performed on an outpatient basis once a week for 3 months, followed by a maintenance course once a month for a year.
Introduction of botulinum toxin (Botox)- The essence of the method is to perform a cystoscopy and submucosal injection of the drug into certain points of the bladder wall. The average duration of the positive effect of treatment is 6-9 months, after which repeated injections may be required.
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