Diagnostics

Overactive bladder in men

The overactive bladder is characterized by a limited capacity to control the urge to urinate. The need to urinate is intense and imminent, without necessarily having a full bladder. Urinary frequency is increased day or night, and there may be associated leakage.

This condition worsens with age and is often the product of a benign enlarged prostate.

What diseases can give symptoms of overactive bladder in men?
  • Diabetes, multiple sclerosis, Parkinson's disease
  • Recent pelvic surgery (eg. lower bowel surgery or intervention on the bladder or reproductive organs)
  • Spinal cord injury, stroke, Alzheimer's disease
  • Urinary tract infections
  • A benign enlargement of the prostate
  • Bladder stones
  • A tumor or inflammation of the bladder.
  • Chronic pelvic pain syndrome or prostatitis
  • Nocturnal polyuria
What are the symptoms of an overactive bladder in men?
  • Frequent urges to urinate (pollakiuria)
  • Urgent needs to go to the toilet, with the apprehension of having to urinate at inappropriate times (urgency).
  • Urine leakage when the person cannot get to the bathroom in time (urge incontinence).
  • What are the risk factors for an overactive bladder in men?
    • Increased consumption of caffeinated drinks
    • Urinary tract infection
    • Nervous system disorders
    • Problems with the pelvic floor (eg. hypertonicity)
    • Pain in the pelvic floor
    How can an overactive bladder in men be prevented?
    • Maintaining a good restraint by avoiding going to the toilet unnecessarily
    • No limiting your hydration, but by drinking differently
    • Avoiding certain drinks that are irritating to the bladder, such as: alcohol, caffeinated drinks, carbonated drinks, acidic fruit juices
    • Avoiding certain foods: citrus, spicy foods, vinegar, chocolate
    • No drinking after supper or three hours before bedtime
    • Systematically emptying the bladder before going to bed
    • Maintaining a functional pelvic floor to maintain adequate muscle support
    • Treating the symptoms of a benign hypertrophy of the prostate (if present)
    How is an overactive bladder in men diagnosed?
    • If there are signs and symptoms of an overactive bladder and they become bothersome, Dr. Marois will ask for tests or tests to make the diagnosis. These may include the following: Medical history and physical exam
    • Digital rectal examination Questionnaire to assess the severity of bladder and BPH disorders and how they affect quality of life
    • Urinalysis
    • Urinary log, over multiple 24 hour periods
    • Blood tests (ex: APS and creatinine)
    • Kidney or bladder ultrasound
    • Post-urination bladder ultrasound to determine how much urine remains in the bladder after urination
    • Cystoscopy
    • Urodynamic assessment
    What are the non-pharmaceutical treatments for an overactive bladder in men?
    For treatments for overactive bladder to be effective, one has to be fully committed to the treatment, which mat consist of :
    • Various lifestyle changes (eg. avoiding caffeine and alcohol)
    • Supervised bladder rehabilitation
    • Various exercises in perineal physical therapy, to limit the urge to urinate
    • Stimulation of the tibial nerve (located at the ankle) and playing an important role in the management of the bladder. This technique is taught in Marois clinics.
    What are the pharmaceutical treatments for an overactive bladder in men?
    • In older men with BPH, treatment that addresses the symptoms of emptying can contribute to the symptoms of an overactive bladder.
    • Specific drugs to reduce the number of urgess and limit leaks.
    • Anticholinergics are thought to work by blocking the stimulation of the detrusor, which causes involuntary contractions. The anticholinergics available in Canada are Darifenacin, Fesoterodine, Flavoxate, Oxybutynin, Solifenacin, Tolterodine and Trospium. Most of these drugs are available as tablets and some are taken only once a day. Oxybutynin is also available in the form of transdermal patches or gel.
    • The most common side effects are dry mouth and constipation.
    • Mirabégron is a new type of overactive bladder medication that does not cause constipation or dry mouth.
    What are the surgical treatments for an overactive bladder in men?
    • Intra-vesical Botox injections (link to Botox page) are offered when oral medications are poorly supported or insufficiently effective in controlling the symptoms of an obstructive overactive bladder. This is the least invasive option and very well tolerated.
    • An enlargement of the bladder (enlargement enterocystoplasty) is also an option, but is rarely performed given the risk of complications.
    • A urinary diversion with an ileal duct is also possible, but rarely performed for this condition.

    Treatments offered to men at Cliniques Marois

    Rapid exams at Cliniques Marois

    Request an Appointment

    Dr. Marois is a urologist who is not a member of the Régie d’Assurance Maladie du Québec (RAMQ). As such, the clinic can not claim the RAMQ for the payment of his services. If you consult Dr Marois, you must pay for the services rendered.

    Cancellation of appointment:

    To ensure the smooth running of the clinic and a minimum of courtesy towards other patients and our staff, we ask you to notify us 48 hours in advance for the cancellation of a consultation, 5 working days in advance for a surgery at the office and 21 working days in advance for a major surgery. If these deadlines are not respected, a cancellation fee of 50% of the service will be charged.

    Change of appointment:

    We understand that events occur, so we ask you to provide us with at least a 24-hour notice for any change in their appointment; we will be happy to accommodate you, the best we can. However, if you fail to inform us within this timeframe or do not show up, we will charge a $ 100 fee.

    Thank you for your understanding.

    Attach a file