pundi kencing terlalu aktif

Kencing yang terlalu kerap dan tidak sempat-sempat memang menimbulkan masalah dalam kehidupan seseorang kerana ia boleh mengganggu aktiviti hariannya. Keadaan ini selalunya dikenali sebagai pundi kencing terlampau aktif (OAB).

Kenapa dikatakan pundi kencing terlampau aktif?

Pengidap penyakit pundi kencing terlampau aktif (OAB) selalunya kencing lebih daripada 7 atau 8 kali sehari dalam keadaan tergesa-gesa atau tak sempat-sempat, atau terjaga tidur 1 atau 2 kali semalam untuk bangun kencing.

Keadaan ini terjadi kerana saraf yang menghantar isyarat ke otot di sekeliling pundi kencing untuk mengeluarkan air kencing tidak selaras dengan saraf yang menghantar isyarat ke otot uretra untuk terbuka. Ini menyebabkan rasa untuk kencing, terutamanya apabila melihat air mengalir, datang tiba-tiba walaupun pundi kencing belum penuh.

Penyakit atau masalah ini mungkin disebabkan oleh infeksi salur kencing, kecederaan saraf, batu karang dalam pundi kencing, diabetes, penyakit ginjal lain, kesan daripada ubat atau penyakit lain yang berkaitan.

Bagi mengesan seseorang itu mengidap penyakit ini, beberapa ujian boleh dilakukan seperti cystometry (menguji kebolehan pundi kencing menyimpan air kencing, keupayaan mengesan kepenuhan air kencing, dan mengesan otot pundi kencing yang terlampau aktif), menyukat jumlah air kencing yang berbaki dalam pundi kencing selepas kencing, urinalysis (menganalisis kandungan air kencing), dan uroflowmetry (menyukat kelajuan dan isipadu air kencing).

Penyakit ini boleh dikurangkan dengan mengurangkan pengambilan minuman berkafein, alkohol, coklat, tomato, limau, makanan berempah, serta melakukan senaman atau latihan kemut otot bagi memberhentikan air kencing keluar sambil duduk. Selain itu, ubat bagi mengurangkan pengecutan otot pundi kencing tanpa disedari juga boleh digunakan, di samping pembedahan dan penggunaan botox sebagai rawatan alternatif.

Keterangan lanjut dipaparkan dalam artikel berikut…

Treating and Coping With Overactive Bladder
Reviewed by Brunilda Nazario, MD

What is Overactive Bladder?
How often do you use the bathroom in a typical day? Is it more than seven or eight times — and you can’t wait? Are you getting up more than once or twice a night to urinate? You may have overactive bladder. At least 30 million Americans suffer from OAB. The need to urinate urgently at unpredictable times can cause problems with your career, social life, and relationships.

How the Bladder Gets Confused?
Your body stores urine in the bladder. Nerves signal the muscle that surrounds the bladder — the detrusor muscle — to contract and expel urine. Other nerves signal the urethra to open, which allows urine to flow. Research shows that multiple factors can cause incontinence OAB. Signals from the sacral nerves to the bladder may cause the detrusor muscle to contract, even if your bladder isn’t full (called detrusor overactivity).

OAB vs. Incontinence
Just because you have OAB doesn’t mean you’re incontinent. About 2/3 of women with OAB are “OAB dry” and can make it to the bathroom in time. They may have an urgent need to urinate and urinate frequently. But they can still control the urges. Others are “OAB wet,” meaning that they have urine leakage along with their OAB. Usually, this is urge incontinence, which is leakage after a sudden strong urge to urinate.

What Causes Signal Problems?
Sometimes the cause of OAB is simple and easily treated, like a urinary tract infection. Other possible causes include nerve damage from injury or pelvic surgery, bladder stones, diabetes, kidney disease, side effects of certain drugs, and neurologic disorders like Parkinson’s disease, stroke, or multiple sclerosis. But often, the cause of OAB remains a mystery.

How Bad Is It?
Your doctor may ask you a series of questions to determine just how much OAB is disrupting your life. On a scale of one to five, for example, you may be asked to assess how much you’ve been bothered by things like accidental losses of small amounts of urine, frequent daytime urination, and waking up at night to urinate. You also might be asked to keep a voiding diary.

Diagnosing OAB
Several tests can help pinpoint the cause of your OAB:
Cystometry — Checks the bladder’s capacity for storing urine, your ability to sense fullness, and helps detect detrusor overactivity
Postvoid residual volume — Measures the amount of urine left in your bladder after urination
Urinalysis — Tests the composition of your urine
Uroflowmetry — Measures your urine’s speed and volume

Lifestyle Treatments
To ease the effects of OAB, cut down on caffeinated drinks, alcohol, chocolate, tomatoes, citrus, and spicy foods. Many people with OAB limit the fluids they drink in a day. But cutting fluid intake too much can result in concentrated urine, which can irritate the bladder. A high-fiber diet can prevent constipation, which also aggravates OAB. Talk to your doctor. She may teach you to retrain your bladder by practicing scheduled voiding.

Pelvic Floor Exercises
Your doctor may suggest pelvic floor exercises called Kegels. You can covertly do Kegels anywhere — in the car, in a meeting, while watching TV. Just squeeze and hold the muscles you use to stop the flow of urine. Then release and repeat. Sometimes biofeedback therapy can help teach you which muscles to use and help measure your muscle strength.

Medications for OAB
If diet changes, pelvic exercises, and behavioral treatment don’t relieve OAB symptoms, the next step is often medication. Anticholinergics are the most common OAB medications — acting on receptors in the detrusor muscle to suppress involuntary contractions. They are taken by mouth at least once a day. Topical estrogens — vaginal rings, tablets, or creams — are also prescribed to women to treat OAB symptoms.

A Stimulator for Your Bladder
For those who have been unsuccessful with more conservative treatments, a pacemaker-like device for the bladder can be used to stimulate the sacral nerves. This device is surgically implanted through a tiny incision above the tailbone, via outpatient surgery. Another alternative, done in the doctor’s office, is periodic stimulation of the posterior tibial nerve (found near the ankle, surprisingly) to help improve voiding dysfunction.

Botox for Your OAB
Botox isn’t just for your forehead anymore. Doctors inject the drug directly into various sites in the bladder muscle, partially paralyzing it to reduce overactivity, but leaving enough control to empty your bladder. Just as with wrinkles, the Botox effect only lasts so long.

Other OAB Surgical Options
If you’ve tried all other options for control of your overactive bladder without success, you may consider another surgery. The primary surgical option for OAB is bladder augmentation — enlarging the bladder with a patch made from your own tissue. Considered major surgery, this procedure is rarely performed.

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