What Is Overactive Bladder? Symptoms, Causes, Diagnosis, Treatment, and Prevention

过度活跃的膀胱（OAB）是一种健康状况，由频繁的迫切需要小便。

Rather than a disease in its own right, overactive bladder is a category of urinary symptoms. It can result from a number of different diseases and health conditions.

膀胱过度活动的人往往会突然敦促他们无法控制自己，因此有些人会泄漏尿液（称为尿失禁）。

You may need to get up and urinate many times during the day or night if you have this condition. (1)

Overactive bladder falls under the larger umbrella of bladder control problems, and it overlaps with urgency incontinence, or尿失禁由于紧迫性。但是，并非所有患有膀胱过度活跃的人都会遭受尿失禁。（（2)

Symptoms of overactive bladder vary from person to person, and may include:

• Sudden, urgent need to urinate
• Difficulty holding in urine
• 尿频（（often eight times or more within 24 hours)
• 迫切需要小便的尿液损失（紧迫性尿失禁）
• 晚上醒来一次或两次小便（夜尿)

The defining symptom of overactive bladder is sudden, strong urges to urinate. You may fear that you’ll leak urine on the way to the bathroom.

Even if you don’t actually leak urine,OAB can disrupt your life和may cause significant distress. (1,3)

Overactive bladder happens when your bladder muscles contract (squeeze) too readily, giving you a stronger or more frequent urge to urinate.

这个问题可能是由于膀胱排空，过度活跃的膀胱肌肉或大脑的神经信号不当而引起的，这些神经信号告诉您的膀胱收缩。

几个不同的健康问题可能会导致膀胱过度活动，包括以下内容：

• 神经系统疾病或损害（包括stroke和multiple sclerosis)
• 糖尿病
• 激素周围变化绝经in women
• Weak or spastic pelvic muscles
• Urinary tract infection（（UTI)
• Drug side effects
• Excess caffeine or alcohol intake
• Bladder abnormalities (such as tumors or bladder stones)
• Enlarged prostate在男人
• 便秘
• Declining cognitive function associated with age

You’re more likely to experience overactive bladder as you age, but this doesn’t mean it’s an inevitable or normal part of aging.

有效治疗或管理有助于OAB的潜在健康状况可能有助于减轻您的尿症状。（1,3）

Learn More About Causes of Overactive Bladder

Your doctor will base a diagnosis of overactive bladder on your history of symptoms and other health conditions, a physical exam, and possibly certain screening tests.

为了帮助诊断OAB，您的医生可能会询问您以下情况：

• Your specific symptoms
• How long you’ve had your symptoms
• Your history of other health problems
• Prescription and over-the-counter drugs you take
• Your diet and fluid intake

You may be asked to keep a bladder diary for a few days, which tracks your urination habits as well as your beverage intake and activities throughout the day.

Your doctor will examine you to see if any physical problems in your pelvic region are putting extra pressure on your bladder.

测试还可以帮助揭示你是否有一个正ection or a structural problem with your bladder, as well as show how your bladder responds to pressure and whether it fails to empty completely.

膀胱功能测试（尿动力学测试）可能测量以下方法：

• How much urine is left in your bladder after urination
• Volume and speed of your urination (urine flow rate)
• Your bladder pressure

Taking these measurements may involve a variety of equipment and techniques, including an超声扫描膀胱，将细管（导管）插入膀胱中，将小管插入测量装置（Uroflowmeter）或将压力传感器插入您的阴道或直肠。（1,3）

过度活跃膀胱的预后

Overactive bladder is a set of symptoms, not a disease in its own right. How long your OAB lasts, and whether it gets better or worse, will depend on the underlying causes.

You may be able to reduce the burden of OAB through lifestyle changes, drug treatments, or certain nonsurgical or surgical procedures. (1)

了解有关诊断过度活跃膀胱的更多信息

在某些人中，过度活动膀胱是健康状况可能会随着时间或治疗而改善的结果。在其他人中，OAB是由持久或永久健康问题引起的。

How long your OAB lasts will depend on its specific causes, as well as how effective your treatments are for both underlying conditions and OAB.

Even if your OAB doesn’t go away completely with treatment, you may be able to reduce its severity or impact on your life. Doing so may include both lifestyle changes to reduce your symptoms and adaptive measures to prepare for symptoms. (1)

Overactive bladder may be treated with lifestyle changes, drugs, office procedures, implantable devices, or surgery.

Guidelines from the American Urologic Association to treat non-neurogenic OAB, updated in 2019, recommend asfirst line treatment behavioral therapies such as

• bladder training
• bladder control strategies
• pelvic floor muscle training
• fluid management (4)

如果生活方式措施还不够，您很可能会开处方一小剂量的药物，可以根据需要增加来控制症状。

如果药物没有提供您需要的救济，您的医生可能会给您Botox (botulinum toxin) injections帮助放松膀胱肌肉。

Both office-based procedures and implantable devices can deliver electrical impulses to the nerves that communicate with your bladder, helping it relax.

In rare cases, your doctor may recommend surgery to increase your bladder’s capacity or to remove it completely.

Medication Options

Your doctor may prescribe drugs to help your bladder muscle relax, including the following categories:

• 反毒品
• Beta3-agonists

这些药物有助于防止您的膀胱在整个过程中收缩，从而有助于限制全天小便的冲动数量。

您可以将这些药物用作药丸，或用透皮斑块作为药丸，从而将药物从皮肤上输送出来。

如果常规药物治疗不足以控制您的OAB，您的医生可能会建议Botox注射以帮助您的膀胱放松。

注射肉毒杆菌素你的膀胱,your doctor will give you a local anesthetic and inject the treatment directly into your bladder muscle. Doing this requires passing a tiny tube with a camera, knowns as a cystoscope, into your bladder.

OAB的肉毒杆菌毒素治疗可能长达六个月。（4）

非手术和外科手术

如果药物无法有效治疗过度活跃的膀胱，则可能是某些程序的候选人。

Nerve stimulation, also known as neuromodulation therapy, sends electrical impulses to nerves that connect the bladder and the brain to help them communicate more effectively.

神经刺激有两种主要类型：经皮胫骨神经刺激（PTN）和s骨神经调节（SNS）。第一个涉及一系列办公室治疗，而第二个涉及手术植入膀胱起搏器。

In very rare and serious cases, surgery may be considered to enlarge the bladder or change the flow of urine. (1)

Complementary, Alternative, and Integrative Therapies and Practices

There may be steps you can take on your own to improve your bladder control, either with or without medical therapies.

Keeping a bladder diary — tracking your urination as well as food and beverage intake, and other activities — can help you figure out what foods or behaviors might contribute to OAB.

改变排尿行为可能有助于训练大脑以更常规的方式发送信号以排尿。可能有帮助的技术包括：

• Double voiding (trying to urinate again immediately)
• Delayed voiding (waiting a few minutes to hours when you get the urge to urinate)
• Timed urination (urinating only at scheduled times)

在尝试任何一个技术之前，最好与您的医生讨论这些技术。

您也可能会从使用骨盆底肌肉的运动中受益，包括以下内容：

• KegelsThis exercise involves squeezing your pelvic muscles tight for a few seconds, then relaxing and repeating this for a set number of repetitions.
• Quick FlicksWhen you have the urge to urinate, you may be able to help control it by quickly squeezing and relaxing your pelvic muscles over and over. (1,3)

Consult Your Doctor About Herbs, Botanical Medicines

While there are also some herbs and botanical medicines and combination of herbs from traditional Chinese medicine that have been used traditionally or have been explored to help reduce OAB symptoms, research is limited and variable in quality and conclusions. Before starting an herbal remedy, especially if planning to take longer term, its best to speak to your urologist, primary care provider, or anintegrative medicine physician。（（5)

了解有关过度活跃膀胱治疗的更多信息

Prevention of Overactive Bladder

Following a healthy diet and getting enough physical activity can help improve bladder symptoms by strengthening muscles in your torso, ensuring bowel regularity, and helping you maintain a healthy body weight.

某些食物和成分会刺激您的膀胱， 和you may want to keep a diary to figure out whether any are contributing to your symptoms.

Foods and beverages that may contribute to OAB include:

• Coffee
• 茶
• 含酒精的饮料
• 碳酸饮料
• Citrus fruits
• Tomato-based foods
• Chocolate
• Spicy food

By avoiding foods that give you problems, you can potentially reduce your symptoms enough to give other therapies a better chance to work.

In addition, you can do exercises to condition and strengthen your pelvic floor muscles. These exercises may help you resist the urge to urinate and reduce urine leakage. (1,3)

了解有关预防膀胱过度活动的策略的更多信息

Overactive bladder can have a significant negative impact on your quality of life. It can interfere with work, sleep, exercise, your social life, and your sex life.

Many people with OAB are nervous about having access to a restroom outside their home and may shy away from certain social activities or even everyday errands. This, in turn, may result in feeling isolated and lonely.

If you need to get up several times during the night to urinate, it may be difficult to get restful sleep. This can leave you tired during the day and contribute to mood disorders, likedepression and anxiety。

而且，如果您担心性活动会引起不适，那么您会因小便的需求而打扰您，或者您会泄漏尿液，那么您可能不愿意进行性爱。这可能会损害人际关系，从而导致进一步的情感困难。

In addition, urine leakage can lead to skin problems or infections. (1,3)

Estimates as high as 30 percent of men and 40 percent of women will develop symptoms of overactive bladder at some point in their life, according to the American Urological Association. (1,6)

In addition, almost one-half of all women will leak urine at some point, and as many as one in three older men leaks urine, according to the according to the National Institute of Diabetes and Digestive and Kidney Diseases. (2)

It’s important to note that these numbers may underestimate the extent of overactive bladder, since many people are reluctant to report their symptoms due to embarrassment or lack of knowledge that treatments are available. (1)

根据最近的两项研究，在不同的种族和族裔群体之间，过度活跃的膀胱的频率和表现不同。

One study, published in February 2020 in the journalFemale Pelvic Medicine & Reconstructive Surgery,looked at the severity of OAB symptoms in women of different races and ethnicities. (7)

在研究小组中，黑人妇女更有可能经历尿液紧急和频率，而西班牙裔妇女则更有可能患有混合尿症状。

与白人妇女相比，黑人妇女的膀胱肌肉过度运动的可能性是3.4倍。与白人女性相比，西班牙裔妇女的尿量明显少得多，而白人妇女则在“强烈渴望”小便的感觉上。

另一项研究，于2020年9月发表在泌尿外科杂志,看着OAB和紧迫性尿失禁(泄漏你的ine due to urgency) in men age 60 to 98 through an incontinence self-reported survey. (8)

研究发现，非西班牙裔黑人的紧迫性尿失禁患病率最高，为13％。西班牙裔男子的收入为11.3％，非西班牙裔白人男性为6.8％，中国族裔男子为2.9％。

过度活跃的膀胱与许多其他膀胱和尿液状况不同，但与之相关。

All of these conditions may be called bladder control problems. Healthcare providers may refer to them as lower urinary tract symptoms (LUTS).

其他不应该与过度活动膀胱相混淆的条件包括：

压力尿失禁This refers to urine leakage due to movement, which puts pressure on your bladder. It can be caused by coughing, sneezing, laughing, or physical activity.

反射尿失禁This refers to urine leakage without any warning or urge. It’s often caused by damaged bladder nerves.

Overflow IncontinenceThis condition can affect people who have difficulty fully emptying their bladder. As a result, the bladder can more easily overflow and leak as a result.

Functional IncontinenceThis happens when an outside barrier, such as a physical or mental disability, prevents someone from reaching a toilet in time to urinate, resulting in urine leakage.

Temporary Incontinence尿液泄漏可能是由于暂时性疾病而发生的，例如不良咳嗽。

床润湿Also known as nocturnal enuresis, bed-wetting can affect adults as well as children. It may be worsened by certain medicines or by consuming caffeine or alcohol late in the evening.

Certain health problems may cause both bed-wetting and frequent nighttime urination. These conditions include肾结石， 一个尿路感染（（UTI），enlarged prostate， 和阻塞性睡眠呼吸暂停。（2）

Interstitial Cystitis and Overactive Bladder

Overactive bladder is also one of the mainsymptoms of interstitial cystitis (IC)， 一个condition with symptoms including intense pelvic pain, bladder frequency, and bladder urgency.

间质性膀胱炎是一种频谱障碍，在某些患者中可能是轻度的，而另一些患者则是严重的。尽管IC曾经被仅视为膀胱状况，但现在被视为膀胱，骨盆底肌肉和通常是神经系统的状况。医疗专业人员说，需要解决病情的各个方面才能进行治疗。

Learn More About Interstitial Cystitis

Favorite Organizations for Information Related to Overactive Bladder

泌尿外科护理基金会

This online resource from the American Urological Association gives detailed information on a wide variety of conditions affecting the urinary tract. There’s also a blog on the site called CareBlog, which shares personal stories from patients and nuggets of advice from experts.

MedlinePlus — Overactive Bladder

美国国家医学图书馆的此网页包含了许多OAB资源的链接，包括有关诊断测试的信息，保留膀胱日记和尿路成像。

National Institute of Diabetes and Digestive and Kidney Diseases — Bladder Control Problems

该国卫生研究院（NIH）部门的该在线门户包含有关各种膀胱问题的信息，涵盖了症状，治疗和临床试验等主题。

National Association for Continence

This organization provides information and support concerning incontinence — bladder or bowel leakage — to patients, caregivers, and medical professionals.

美国泌尿生产学会

这个专业组织提供有关乌拉妇科医生所做的事情以及如何从中受益的信息。