Overactive Bladder (OAB)
An overactive bladder is when a person regularly gets a sudden and strong urge to pass urine, even if the bladder isn’t full. This can happen during the day or night, often coming on without any warning.
Overactive bladder syndrome
People with an overactive bladder (OAB) frequently experience a sudden, strong and urgent need to pass urine – even if their bladder is not full. It’s often associated with a feeling of ‘when you’ve got to go, you’ve got to go’, where you can’t control or ignore the need to urinate. It can happen during the day or night, and can come on without any warning.
Many people with OAB fear they will leak urine, or they’ll experience an accident before reaching the safety of a toilet. Understandably this has a significant impact on their quality of life with worries about needing to be close to a bathroom, disrupted sleep at night, and an impact on relationships with family and friends. It’s no wonder people with an overactive bladder can find it tiring and upsetting.
The good news is treatments are available to help manage your symptoms. Our consultants at The Urology Partnership are experts in assessing and understanding how OAB affects each patient. Before providing personalised treatment plans focused on helping you achieve your treatment goals.
Mr. Bob Yang currently leads the whole NHS OAB pathway across the Thames Valley, encompassing Berkshire, Oxfordshire and Buckinghamshire.
What causes an overactive bladder?
An overactive bladder is due to a fault in the urinary tract. When you have a full bladder the brain sends a signal to the bladder to contract its muscles to force the urine out through the urethra. The sphincter in the urethra opens and urine flows out.
With a healthy bladder, when your brain signals your bladder is getting full (or is full) you can wait to pass urine. With an overactive bladder, you can’t wait and feel an urgent need to urinate. This can happen even if your bladder isn’t full.
Overactive bladder syndrome is common and affects both men and women and people of all ages. For many the exact cause of OAB is unknown, but there are certain factors which can place people at higher risk:
- Neurological disease such as multiple sclerosis, Parkinson’s disease, stroke or diabetes can affect nerve signals and bladder control.
- Prostate problems where the prostate is enlarged can cause obstructions making it difficult to empty the bladder completely, causing it to contract more often.
- Hormone changes when oestrogen levels decline during menopause this can lead to weakened bladder muscles and increased OAB.
- Urinary tract infections (UTIs) can irritate the bladder causing strong urges to urinate.
- Lifestyle factors such as drinking too much alcohol or caffeine can irritate the bladder, leading to stronger urges to urinate.
- Other factors including obesity, anxiety and smoking can also contribute to experiencing OAB symptoms.
Symptoms of Overactive Bladder (OAB)
Those with an overactive bladder often experience a range of incontinence symptoms including urgency, frequency and waking in the night due to the need to pass urine.
- Urge incontinence (also known as urgency incontinence) is when your bladder suddenly contracts without warning and you experience a sudden, strong and urgent need to urinate. These sudden urges to urinate are often accompanied by involuntary urine leaks.
- Urinary frequency is where you need to pass urine more often than usual and in small volumes. Typically most people pass urine 6 to 8 times per day. Frequent urination is when you have to pass urine more than 8 times in 24 hours. However, this can be influenced by how much you drink in the day and types of fluid you drink, as well certain medications like diuretics.
- Nocturia (passing urine at night) is when your sleep is interrupted by the need to get up in the night to pass urine. Getting up more than twice per night can indicate an OAB problem.
While these symptoms are all commonly associated with an overactive bladder, they can also be due to other conditions such as a urinary tract infection (UTI). For this reason, it’s important for your symptoms to be properly assessed and diagnosed by a healthcare professional.
Diagnosing Overactive Bladder (OAB)
Our initial assessment involves asking you questions about the urinary problems you’re experiencing and your general health.
Alongside this we might check your urine flow rate, bladder emptying and your urine for any signs of infection. We may also ask you to keep a bladder diary. This diary tracks things like when you pass urine and the volume of urine you pass, how often you get feelings of urgency and if you experience any urine leaks. As well as how much and the type of fluid you drink, and when you drink it.
We may also recommend a separate appointment for urodynamic testing to look at how well the bladder, sphincters and urethra are storing and releasing urine.
This information will help us understand which treatment options are most suitable for you, based on severity of your symptoms and what you’d like to achieve as a treatment goal.
Treatments for Overactive Bladder (OAB)
At The Urology Partnership we offer a range of treatment options for an overactive bladder. From making changes to your lifestyle, to having bladder muscle relaxing injections.
Lifestyle changes
The first step is usually to explore if making lifestyle changes has a positive impact on your symptoms. These changes could include:
- Avoiding foods that irritate the bladder such as spicy food and tomatoes and eating more foods high in fibre.
- Changing drinking habits to avoid drinks such as tea, coffee, alcohol and citrus fruit juice and replacing with drinks less likely to cause bladder irritation like water, herbal and fruit tea, milk and diluted squash. As well as keeping an eye on how much you drink and when you drink to manage when you need to urinate.
Bladder training
Bladder training may also be suggested to help you regain control of your overactive bladder by suppressing the need to urinate. Training starts by creating a regular urination pattern – on the hour every hour from the time you get up to the time you go to bed. Even if you don’t need to go.
Between these set urination times you will need to attempt to hold your urine as soon as you get a strong urge to go to the toilet. After 2 to 4 days, once you have mastered the technique of suppressing your bladder contractions, you can gradually increase the amount of time in between passing urine.
Pelvic floor physiotherapy
Specially tailored Kegel exercises build up the strength within the muscles of the pelvic floor, which controls bladder incontinence. Up to 50% of patients will experience a considerable improvement in their symptoms using the correct physiotherapy alone.
Our urology nurses will guide you through each set of techniques to ensure you get the most out of each exercise to maximise the effectiveness.
Treatment may include the new Emsella chair. A revolutionary non-invasive and comfortable physiotherapy treatment for urinary incontinence which stimulates and strengthens the entire pelvic floor musculature. One 28-minute session of Emsella is equivalent to doing 11,000 pelvic floor exercises.
Medications
If conservative measures have failed you might be offered medications to reduce the symptoms of an overactive bladder. These work by reducing the sensitivity of the nerves that go to the bladder. They are usually once a day medications.
The medication blocks nerve signals to the bladder muscle, which reduces its ability to contract. This leads to 3 main benefits:
- Reduced bladder spasms = Fewer sudden urges to urinate.
- Increased bladder capacity = The bladder can hold more urine before needing to empty.
- Improved bladder control = Less frequent and less urgent urination.
Bladder muscle relaxing injections
For people with an overactive bladder who haven’t found relief with traditional treatments, bladder injection therapy can be a real game-changer. It works by helping to relax overactive bladder muscles through injecting muscle relaxing medication into the bladder muscle. Similarly to medications this reduces spasms and leakage while increasing capacity and control.
These can be done under local anaesthetic in the comfort of our outpatient clinic and patients can go home almost immediately afterwards and are often very satisfied with the results and improvement in symptoms.
Fast access to help for an overactive bladder
If you are experiencing symptoms of an overactive bladder and would like help, please contact The Urology Partnership and we will make an appointment to see one of our OAB specialists within a week.
You may call us on 0118 920 7040 or request an appointment.
Next Steps
Get fast access to leading specialists for the swift diagnosis and treatment of urological conditions in a private clinic environment.
If you would like more information or wish to arrange a consultation with one of our specialist consultant urological surgeons then please either Call 0118 920 7040 or complete the form below.
Insured patients
Contact your GP and ask for a referral to the Urology Partnership.
All consultations, investigations and treatments are covered by major insurance companies (depending on policy).
Funding your own treatment
Self-funding initial consultation fee is £205. Follow up fees are £165.
Consultation charges are exclusive of any tests and other investigations that the consultant may wish to carry out.