Overactive bladder

Last updated on 12th September 2015

What  is it?

An overactive bladder typically gives rise to symptoms that include going to the toilet too often (“frequency”), getting up at night to pass urine (“nocturia”), a compelling or desperate desire to pass urine(“urgency”), and sometimes not being able to make it in time to the toilet (“urge incontinence”).  It is a common condition, and many women will have a degree of these symptoms before seeking medical attention. It may be necessary for you to have a special test on your bladder to help diagnose the problem (“urodynamics”).

What causes it?

There are numerous suggested reasons for developing an overactive bladder.  During the normal process of urinating, the bladder muscle squeezes or contracts, in order to expel urine or pass water.  At other times, like a balloon, the bladder is able to gradually fill, and with time sends signals to the brain that it is filling or is getting full. For women with an overactive bladder, the bladder inappropriately squeezes, or squeezes with only small amounts of urine inside. This squeezing action gives rise to the unpleasant sensation of urgency, and often occurs at socially inconvenient times. The squeeze may be of sufficient force that urinary leakage results.

What are the treatments?

There are many treatments for women who have symptoms of an overactive bladder. Lifestyle factors are important, and involve reducing excessive fluid intake and avoiding caffeinated drinks (such as tea and coffee) and alcohol.  In addition, pelvic floor and bladder re-training is useful to control symptoms, and some women find acupuncture an effective therapy.  We have a team of nurse specialists, continence advisors and physiotherapists who will be able to direct you with these treatments.

Many women are treated with medical drugs to help improve their symptoms.  There are a variety of different drug preparations used, and many women find that they help to control some of the symptoms of an overactive bladder.  As with most medication, there can be side effects which are often most noticeable in the first few weeks of treatment and may settle down with time.  Typically these include a dry mouth and constipation.  Some women need to try different preparations to find the most appropriate one for them.

If drug treatment is unsuccessful, there are possible surgical treatments, including injecting botox into the bladder, or using a special electrode device that helps control the nerve signals to and from the bladder (“sacroneuromodulation”). These are highly specialised treatments that can be discussed further with you.

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