Do you suffer from having the urge of passing urine at any time of the day or night uncontrollably? Then you may have a condition called “Overactive Bladder.” We know how getting caught up in this situation can be awkward and embarrassing for anyone, especially when the urge to pee then leads to a bit of a leak in your undies while you make your way to the loo. Good news: there are various ways available to treat overactive bladder. Read through this article to know more.
Understanding how the bladder works
Before jumping into the different treatments for overactive bladder, it is important that we gain knowledge about how the bladder works.
One of the ways that our body releases wastes and toxins is by releasing urine. Urine is produced in the kidneys, which is then collected in the bladder. To release urine from the bladder, it passes through the urethra, which is a tube that connects the bladder to the opening of the vagina or penis. The urethral opening is controlled by a muscle called the sphincter. Once the bladder is full of urine, the brain receives nerve signals that signify the need to pass urine. When this happens, the sphincter begin to muscles relax and open as the bladder’s muscles contract to push the urine out of the body.
A person with an overactive bladder, however, experiences bladder contractions even when there is a low amount of urine present in the bladder. These bladder contractions cannot be controlled and they trigger the need to urinate immediately.
Why does this condition happen?
There are a lot of reasons why an individual may suffer from an overactive bladder. The symptoms are often linked to persons undergoing the following conditions:
- Bladder tumours or stones
- Changes in hormones for menopausal women
- Enlarged prostate in men
- Neurological disorders
- Urinary tract infections (UTI)
Likewise, an overactive bladder may also be due to:
- Challenges in mobility (e.g. difficulty in walking)
- Diuretic medications
- Inability to completely release all of the urine from the bladder
- Too much alcohol or caffeine intake
Diagnosing overactive bladder
Overactive bladder is a condition that can happen at any age. It is also more common in women than men. Doctors who specialise in diagnosing this condition are called urologists. To diagnose, a urologist may recommend the following tests for a patient to undergo:
- Bladder scan – This test determines the volume of urine that the bladder has failed to release after urinating. An ultrasound device is used to measure the remaining amount of urine in the bladder.
- Cystoscopy – A medical tool called a cystoscope is inserted into the bladder to check for any abnormalities, such as tumour growths or bladder stones.
- Physical examination – Your doctor will check the areas around your abdomen and kidneys for tenderness. In men, this test will help the doctor confirm if you have an enlarged prostate.
- Urinalysis – This test requires a urine sample from the patient. The urine is subjected to lab tests to see if there is infection or other problems affecting the urinary tract.
- Urodynamic testing – This is composed of several tests that evaluates the ability of the bladder to function normally.
Treating overactive bladder
There are several ways to treat an overactive bladder. The most efficient strategy is to use a combination of methods to overcome this condition, such as:
- Behavioural interventions
- Bladder injections
- Nerve stimulation
Behavioural interventions. The initial choice in dealing with an overactive bladder is therapy that can alter a patient’s behaviour. The methods used in this treatment can be:
- Biofeedback – This uses electrical sensors connected to the body and helps train it to improve your body’s ability to control your bladder. An example of which is to improve your strength in controlling your pelvic muscles to stop the bladder from contracting involuntarily.
- Bladder training – This technique trains your bladder to delay releasing urine whenever you feel the need to go to the toilet. This should only be done when the pelvic muscles are able to contract without any problems.
- Keep a healthy weight – Being overweight or obese causes overactive bladder as the fats around the abdomen area can add pressure to the bladder and trigger the need to urinate.
- Toilet scheduling – Create a schedule for making toilet trips every 2 hours or so rather than only going when the bladder is full and the urge to urinate is there.
- Use an absorbent undergarment or pads – This can help keep your clothes from being soiled in case unexpected leaks happen in the day.
Bladder injections. Botox is not only used for cosmetic improvements, but also to treat overactive bladder. This substance is injected in minimal doses to help the bladder’s muscles relax.
Medications. Medical drugs can be prescribed by your doctor to address your overactive bladder. The usual drugs prescribed are Fesoterodine (Toviaz), Mirabegron (Mybertiq),Oxybutynin (Ditropan XL – pill, Gelnique (gel), or Oxytrol – skin patch), Solifenacin (Vesicare), Tolterodine (Detrol), Trospium.
Nerve stimulation. This procedure uses a thin wire implanted beneath the skin in the lower back. This wire is then activated using a handheld device and sends electrical impulses to the bladder to moderate the rhythm of the nerve. The device works like a pacemaker for the heart.
Surgery. The last resort to treat overactive bladder is surgery. This option is done for patients who have undergone other interventions, but have not seen any improvement in their condition. These invasive procedures include surgery to either improve the bladder’s capacity to contain urine or remove the bladder completely and implanting replacement for urine collection.
Living with overactive bladder
There is no need to be embarrassed to speak with your doctor about having an overactive bladder. This condition is treatable and you can experience a normal life once it is managed. As a start, you will need to make adjustments to your personal lifestyle to improve certain symptoms. For instance, you may need to lose weight if you are overweight. You may also need to reduce your consumption of food and drinks that can cause the bladder to be irritated. Foods and beverages like chocolates, spicy food, citrus fruits and juices, coffee, tea, and alcohol should be avoided.
Dr Ng Kai Lyn – Consultant Obstetrician and Gynaecologist
Mount Elizabeth Novena: 38 Irrawady Road 05-34/35
Hougang: 684 Hougang Ave 8 01-198
+65 60 1115 31