Dealing with an Overactive Bladder (OAB)
When you have an overactive bladder, every part of your everyday life can be affected by it in a negative way. Want to go for a long walk? Only if there will be a handy toilet. Going out with friends? Better make sure you don't drink too much fluid, or you'll struggle to make it back home before you need to wee.
Having overactive bladder might even mean that you wet yourself while you're trying to get your key in the door of your home.
In this article, we'll identify the symptoms of overactive bladder while providing advice for controlling the urinary urgency that comes with it.
What is an Overactive Bladder?
In simple terms, having this medical condition means that you have bladder control issues. You will have strong urges to pee that are difficult or impossible to curb.
You may see this referred to as overactive bladder syndrome, or simply OAB.
Overactive Bladder Symptoms
If you have OAB, you will be affected by some or all of the following symptoms related to bladder control:
Urinary urgency - The sudden need to wee immediately and feeling that if you don't find a toilet straight away, you will wet yourself. You will not necessarily leak urine when this happens to you, but you might. Those occasions when you can't get your front door unlocked fast enough are the times when you're experiencing this problem.
Urinating frequently - The need to wee many times a day. It's difficult to put an exact number on what constitutes "many times" because this will vary from individual to individual and will depend on many factors unrelated to bladder health. For example, if you drink a lot of water, then you will need to go to the toilet more often than a person who drinks less.
Urinary incontinence - If you pee a little — or a lot — when you're feeling the need for the toilet, it's known as urge incontinence. You might also find that you wee a little when you sneeze, laugh or have a physical strain. That type of leaking is called stress incontinence, and these are actually different conditions.
Nighttime urination - It's normal to wake in the night and need the toilet - especially as you get older. But if this happens to you regularly more than once a night, it might be an indication of OAB. The medical term for this condition is nocturia, and it's easy to see how having your sleep interrupted regularly like this would have a negative impact on many facets of your daily life.
Difference Between Frequent Urination and OAB
As we noted above, the number of times a day that you need to wee will vary enormously from person to person. It's not always going to be OAB; ordinarily when you find some of the symptoms of an overactive bladder, it's because you just need to wee a lot. And that can be perfectly normal.
So, how do you tell the difference between needing to urinate a lot compared to a bladder that is overactive in a way that will need medical intervention?
The Bladder and Bowel Community give a helpful guideline that most people will urinate six or seven times in a 24-hour period. Having said that, we recognise that these figures will vary depending on your individual lifestyle and diet. As an example, you could go as often as 10 times in a 24-hour period and still be normal.
Do you need to urinate eight times or more a day, including the night? Are some of them caused by a sudden urge to go? If these are true for you, and you're not aware of any particular reason for it, then it might be that you have OAB.
Diagnosing Overactive Bladder (OAB)
To determine the cause of your urinary symptoms, it's wise to get advice from a medical professional sooner rather than later, as OAB can deteriorate if you don't have treatment. The tests your doctor will apply to decide whether or not your bladder is overactive can include the following:
- Urine test to look for blood or signs of infection
- Medical history to determine whether you have had past conditions that might contribute to this issue
- Physical examination, including pelvic and/or rectal exam
- Neurological investigation
- Tests of bladder function
- Referral to a specialist
Testing Bladder Function
When you're referred to a specialist doctor or clinic, they will conduct tests to discover the reasons for your OAB symptoms.
The purpose of the tests will be to see how well your bladder is working, find out your urine flow rate, the pressure in your bladder and whether you have urinary retention or you're able to empty completely each time you try.
Causes of Overactive Bladder
Bladder activity is triggered by a muscle, the detrusor. It's not one of the pelvic floor muscles, but it is affected by them. If the detrusor doesn't work properly, it causes overactive bladder.
There are a number of conditions that can damage this muscle or interfere with the signals between nerves and brain, including:
- Urinary tract infection
- Side effects from drugs
- Bladder stones
- Kidney diseases
- Nerve damage caused by surgery or trauma to the pelvis or abdomen
- Bladder or prostate cancer
- Brain or nerve diseases like multiple sclerosis or Parkinson's disease or having had a stroke
Treatments for Overactive Bladder
OAB treatment options will normally start with behavioural and lifestyle adjustments that are non-invasive.
1. Conservative Treatment Options
- Bladder training so that you're able to hold urine longer.
- Limiting or avoiding food that irritate the bladder, like alcohol, some citrus fruits, fizzy drinks, tomatoes, chocolate, caffeinated drinks like tea and coffee and some spicy food.
- Double voiding, or peeing and then waiting a few seconds and then trying again; this technique is useful if you have difficulty emptying your bladder fully.
- Pelvic floor muscle exercises and electrostimulation to improve the support of your bladder and the operation of the detrusor.
2. Medical Treatment Options
If changes to your habits don't make a big enough impact on your bladder symptoms, then they may be combined with medical treatment, such as:
- Prescription drugs given in tablet form or applied directly to the skin to relax the bladder muscle or to increase the amount of urine it can hold.
- Botox injections can be an option for some patients, but you will need to repeat them when the OAB symptoms come back.
- Sacral nerve stimulation (SNS) or tibial nerve stimulation (PTNS) to manage the signalling failure between the nervous system and the brain.
3. Surgical Treatment Options
In some rare cases, surgery is a last resort option to treat serious overactive bladder. In these cases, the surgeon will either enlarge the bladder so it can hold more urine or redirect the urinary flow. These surgeries carry high risk, though, so they are only offered when other treatments don't work.
Does Overactive Bladder Ever Go Away?
Depending on the cause, overactive bladder can sometimes be cured. However, it's more likely to be an ongoing condition to be managed. Sometimes the symptoms of overactive bladder can come and go.
If you suffer from OAB or other causes of incontinence, a women's health physiotherapist will be able to devise a treatment plan to help control your symptoms and get back to your life.
For more information about, managing overactive bladder, call Magdalena on 07877 017 936 or drop PelviCare an email. Alternatively, you can book an appointment online or find a full list of the treatments available on our website.
PelviCare Women's Health Physiotherapy is located in Greenwich, London, serving women across South London, East London, Essex, Kent and beyond.