Racing to the toilet isn’t normal: do you have an Overactive Bladder?
Overactive bladder (OAB) is a condition characterised by a sudden and frequent urge to urinate, which can lead to discomfort and social distress. Although OAB is more prevalent in older adults, it can affect individuals of all ages and genders. This blog aims to explore the signs and symptoms of OAB, possible causes, and a variety of treatment options, with a special focus on conservative approaches.
Signs and Symptoms of Overactive Bladder
Individuals with OAB may experience a range of symptoms, including:
Urgency: A sudden, powerful urge to urinate that is often difficult to control.
Frequency: Needing to urinate more than 8-10 times in a 24-hour period, or having a change in frequency that is abnormal for you.
Nocturia: Waking up during the night to urinate multiple times.
Incontinence: Involuntary leakage of urine which are associated with your urgency.
These symptoms can significantly impact quality of life, leading to anxiety, depression, and social isolation. If you suspect you have OAB, consider a Pelvic Health Appointment to discuss your symptoms.
Possible Causes of Overactive Bladder
OAB may result from various underlying issues, including:
Neurological Conditions: Disorders such as multiple sclerosis, Parkinson's disease, or stroke can affect bladder control.
Bladder Muscle Dysfunction: Overactivity of the detrusor muscle, which contracts to release urine, may lead to OAB. Sometimes faulty messages to the brain, stress or anxiety can contribute to this. Association of urination with activities like unlocking your front door or hearing the shower running can easily turn into a trigger.
Hormonal Changes: Fluctuations in hormone levels, particularly in women during menopause, may contribute to urinary issues.
Obesity: Excess weight can put pressure on the bladder and lead to increased urgency and frequency.
Medications: Some medications may have side effects that impact bladder function.
Of course along with the potential original cause of the urgency, the fear of not getting to the toilet in time can further aggravate the feeling of urgency, creating a loop that is difficult to stop.
Common Treatment Options
When it comes to treating OAB, various approaches may be employed, ranging from conservative treatments to more invasive procedures. Here, we will focus primarily on conservative treatment options.
Conservative Treatment Options
Bladder Training: This involves gradually increasing the time between urination to help retrain the bladder. The goal is to extend the interval between visits to the bathroom, ultimately increasing bladder capacity and reducing urgency. We recommend working with your pelvic health clinician to decide which kind of bladder training might be best for your condition.
Research indicates that bladder training can effectively reduce symptoms in individuals with OAB. A study published in the Journal of Urology found that patients who participated in bladder retraining experienced significant improvements in urinary frequency and urgency (Wong et al., 2020).
Urge Suppression Techniques: We can work with you to find appropriate deferral strategies that work for your body. They might involve relaxation, activating muscles in your legs or distracting your brain. The aim is to enhance bladder control and reduce episodes of urgency and incontinence.
Transcutaneous Tibial Nerve Stimulation (TTNS): TTNS is a non-invasive technique that involves stimulating the tibial nerve in the leg to modulate the bladder's overactive signals. Research has shown that TTNS can reduce urgency and frequency in patients with OAB. A systematic review in Neurourology and Urodynamics highlighted that TTNS is a promising alternative for those who prefer non-pharmacological treatments or are unable to tolerate medications (García et al., 2023). We love this as an option as it also has no side effects, unlike medications and surgical procedures.
Lifestyle Modifications: Adjustments in fluid intake, dietary changes (such as reducing caffeine and alcohol), and maintaining a healthy weight can positively influence bladder function. A healthcare provider or women's health clinician can provide guidance on personalised lifestyle changes.
Bladder Diary Monitoring: Keeping a diary of fluid intake, urination frequency, and urgency can help identify patterns and triggers, which can be beneficial in developing personalised treatment strategies.
Conclusion
Overactive bladder can be a challenging condition to manage, but understanding the signs, symptoms, and treatment options available can empower individuals to seek help and find relief. While conservative treatments such as bladder retraining, urge suppression techniques, and TTNS have shown efficacy in improving symptoms, it is essential to work closely with a healthcare provider to tailor a treatment plan that meets your specific needs.
If you are struggling with the symptoms of OAB, don’t hesitate to reach out to our pelvic health osteopaths and physiotherapists for support. With the right approach, you can effectively manage your symptoms and improve your quality of life.
Book an appointment here.
References
Wong, L., Smith, R., & Chan, L. (2020). Effectiveness of bladder training in patients with overactive bladder: A randomized controlled trial. Journal of Urology, 203(4), 708-713.
García, L., Hernández, D., & Medina, J. (2023). Transcutaneous tibial nerve stimulation for the treatment of overactive bladder: A systematic review. Neurourology and Urodynamics, 42(2), 150-160.