I HAVE OAB, DOES THIS MEAN I HAVE NERVE DAMAGE?
Although nerve damage can result in the symptoms of overactive bladder, it is not necessarily the cause. The autonomic nervous system is not under your conscious control. The parasympathetic (PNS) and sympathetic (SNS) nervous systems are both part of the autonomic nervous system. Even though you cannot consciously control these systems, you do have the possibility to train yourself to have some level of control over your sympathetic responses.
When you are potty trained as a child, you learn to read your body’s guarding reflex, which is controlled in part by the PNS and SNS, and in turn to control how your body responds by holding your urine until a bathroom is found. This is an example of gaining control over your sympathetic responses or in lay-mans terms, you could say you are “positively programming” your bladder function.
In the same way, you can “negatively program” your bladder. Negative programming of your bladder is caused by “just incase” peeing (JIC). If you JIC pee, you will change how your SNS interprets the volume of urine in your bladder. This will result in an increase in your frequency of urination; therefore you will pee smaller amounts more frequently. Over time, this can impact the function of your detrusor (bladder muscle) as your sensitive stretch receptions become unfamiliar with the feeling of a full bladder.
Hopefully you have read the description of the urination cycle (micturition cycle) on the urinary incontinence page. You may recall that guarding reflex signals are sent to your external urethral sphincter to increase the level of contraction in conjunction with the increasing volume of urine in the bladder. If you consistently empty your bladder when it is only partially full, this will result in less involuntary increases in contractions of external urethral sphincter. This in turn can reduce the strength of the sphincter which can lead to stress incontinence!
I AM WAKING DURING THE NIGHT TO PEE, COULD THIS MEAN I HAVE OVERACTIVE BLADDER?
As you get older, the likelihood of waking during the night to pee is increased. Waking more than once per night (nocturia) is a symptom of overactive bladder. Nocturia can also be caused by drinking too much before bedtime. If you “just incase” (JIC) pee all the time, this can also lead to nocturia as your bladder may believe it is full when only partially filled.
IS WETTING THE BED A SYMPTOM OF OVERACTIVE BLADDER?
Adult bedwetting (enuresis) can happen with overactive bladder when urge incontinence (UUI) is also present. However, enuresis is more commonly reported in cases of overflow, functional and reflexive incontinence. Enuresis is also common with alcoholism. With both nocturia and enuresis, you should speak to your doctor as interruption of sleep can lead to poor health which will negatively impact your ability to heal thus further reducing your quality of life.
CAN PELVIC FLOOR MUSCLE TRAINING (PFMT) TREAT MY OVERACTIVE BLADDER?
PFMT plays an important role in bladder retraining which is a pivotal overactive bladder treatment, even when you do not experience leakage. As explained on the Urinary incontinence page, contractions of the external urethral sphincter are an automatic response to the guarding reflex. If your bladder is sending signals to say that it is full before time, you need to tap into the guarding reflex. You do this by deliberately contracting your external urethral sphincter, which is a core component of a Kegel, the most basic pelvic floor exercise. Not only does pelvic floor muscle training help with bladder retraining, it is also used to treat incontinence and can help to improve the quality of your orgasms.