“Whether due to discomfort with the topic or a lack of knowledge about treatment options, some women attempt to manage symptoms on their own, a decision that can lead to additional problems…”
Among women 18 to 70 years old, almost a third are “sometimes” affected by the symptoms of overactive bladder, according to the authors of this month’s CE feature, “Overactive Bladder in Women.” This rate is nearly twice that among men, and prevalence is known to increase in all adults as they age.
Overactive bladder can significantly affect daily activities, with many women altering their routines to ensure a bathroom is nearby. The “hallmark symptom of overactive bladder is urgency,” according to authors Mary H. Palmer, PhD, RN-BC, FAAN, AGSF, and Marcella G. Willis-Gray, MD. Women may experience urgency with urinary incontinence, stress urinary incontinence, or mixed urinary incontinence (in which a combination of these symptoms occurs).
A Tendency to Self-Manage
Despite the impact of this condition on everyday routines, patients often resist talking to their health care providers about symptoms—or do so as an afterthought, as the patient does in the hypothetical case study accompanying this article. Whether due to discomfort with the topic or a lack of knowledge about treatment options, some women attempt to manage symptoms on their own, a decision that can lead to additional problems, according to the authors Palmer and Willis-Gray:
As a consequence, they may inadvertently worsen symptoms and increase their risk of developing incontinence and being injured in a fall. Many women are caught in a relentless cycle, experiencing unpredictable urgency, being incontinent, stopping physical exercise to prevent more incontinence, gaining weight, experiencing functional limitation, feeling anxious, and continuing to experience unpredictable urgency and urinary leakage.
Routine Screening and Modifiable Risk Factors
Nurses can help to break this cycle by advocating for and conducting screening among women for overactive bladder symptoms. If a patient reveals she is experiencing symptoms, the nurse can recommend lifestyle and behavioral changes, such as losing weight, modifying fluid intake, and stopping smoking.
If this first-line therapy, as recommended by the American Urological Association, does not lead to an improvement in symptoms, the nurse can then refer the patient to a specialist for additional treatment, which may include the use of antimuscarinic medications or various neuromodulation techniques.
The Role of Patient Education
Palmer and Willis-Gray conclude that nurses can also play an important role in the education of patients, focusing on preventing complications associated with overactive bladder. Women who have urgency with urinary incontinence, for example, are at greater risk of falling. Nurses can encourage them to be vigilant for the first signs of the need to void, in order to avoid rushing to the toilet.