What is overactive bladder syndrome?

Have you ever heard of this term? Or maybe you know a friend who sometimes needs to rush to the toilet to urinate and may leak before getting there? The symptoms include:

  • Urgency:
    • Sudden urgent desire to pass urine. You are not able to put off going to the toilet.
    • Latch key urgency is the name given to the urgent need you might feel to pass urine as soon as you get home and put your key in the door.
  • High frequency:
    • Going to the toilet more often than normal – usually more than 8-9 times a day. 
  • Nocturia:
    • This means waking up to go to the toilet more than once at night.
  • Urge incontinence:
    • This occurs in some people with OAB. It is a leaking of urine before you can get to the toilet when you have a feeling of urgency.

Risk factors?

The cause remains unclear but is believed to stem from multiple factors, some of which you can control and others you can’t. Vaginal birth delivery with 40% of parous women experiencing urge urinary incontinence, older age, obesity, chronic constipation, factors that get in the way of urine leaving the bladder, such as enlarged prostate or previous surgery to treat incontinence, hormonal changes during menopause in women, pelvic organ prolapse.

Causes

The bladder muscle (detrusor) becomes overactive and squeezes (contracts) when you don’t want it to. The bladder contracts too early when it is not very full and not when you want it to. This can make you suddenly need the toilet. In effect, you have much less control over when your bladder contracts to pass urine.

It affects as many as 16% of adult men and 33% of adult women.

Symptoms may become worse at times of stress. Symptoms may also be made worse by caffeine in tea, coffee, cola, etc and by alcohol.

Treatment

First line treatment includes pelvic floor physiotherapy with lifestyle interventions, pelvic floor exercises, timed voiding and bladder-holding techniques using your pelvic floor muscles bladder training. Antimuscarinic medications can be added if these measures fail to control symptoms.

 Overactive bladder isn’t something you should “learn to live with.” By being patient and working with your pelvic floor physio you will more likely than not find a solution to this common urologic disorder.

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