Overactive bladder (OAB)

OAB is when you feel the urge to pass urine frequently and visit the toilet often. If this happens at night, it is called nocturia. Some women with OAB have urinary incontinence as well. Women of all ages may experience bladder issues such as these.

What is the cause of OAB?

The main cause of involuntary bladder muscles contractions. Sometimes this is temporarily caused by urinary tract infections (UTI). In other cases, this can be caused by damage to the nervous system e.g. older age or medical conditions such as diabetes, stroke, dementia etc.

Other causes include:

  • Weakened pelvic floor muscles: because of damage sustained during pregnancy and childbirth, weakening from ageing and menopause, obesity
  • Medication se.g. certain blood pressure or heart medications that prevent fluid accumulation in the body
  • Drinking caffeinee.g. tea/coffee and alcohol: this irritates the bladder

How do I know if I have OAB?

You should consult a urogynaecologist to determine if you have OAB or urinary incontinence, its severity and your treatment options. Your doctor will take a detailed medical history and perform a pelvic examination to check for any pelvic organ prolapse and pelvic floor muscle tone.
Depending on your symptoms, you may require a pelvic and bladder ultrasound scan, urine tests and/or urodynamic study (this is a test to check for your bladder function and bladder muscle stability).

Can this be treated?

You may not be fully cured because this is a long-term condition, but there are many good ways to keep your symptoms under control so that your life does not revolve around your bladder.

Conservative treatment

The first line treatment is lifestyle changes, which are sometimes sufficient to improve symptoms of urge urinary incontinence significantly. These include:

  • Maintaining a healthy weight
  • Adjust your diet or fluid intake
  • Cut down on caffeinated drinks
  • Take scheduled toilet breaks
  • Bladder Training
  • Improving control of medical conditions e.g. diabetes, or changing medications
  • Quit smoking
  • Pelvic floor (Kegel) exercises

Medications

If these do not work, medications are usually added on. These relax your bladder muscle and allow you to increase the intervals that you need to pass urine. There may be some side effects, so you may have to try different drugs before finding one that suits you. There are certain medical conditions that may make you unsuitable to take these medications – do check with your urogynaecologist.

Invasive options

Finally, 2nd line options include bladder Botox injection into the bladder and nerve stimulation. These are invasive options reserved for women who have failed to improve despite all measures and usually need to be repeated as their effects last for 6 months.

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