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Understanding and treating overactive bladder (OAB)

When sudden, uncontrollable urges disrupt your life, effective treatments can help you regain bladder control
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Overactive bladder (OAB) is characterised by a sudden, uncontrolled urge to urinate that may be accompanied by leakage, frequent urination, and waking at night to use the toilet.

If you experience sudden, overwhelming urges to urinate that are difficult to control, or if you’re rushing to the toilet to avoid accidents, you may have an overactive bladder. This common condition affects millions of women and can significantly impact your quality of life, but effective treatments are available.

At The Women’s Health Vulvo-Vaginal & Genitourinary Clinic, we specialise in diagnosing and treating an overactive bladder. Our team can help you regain control and confidence.

An overactive bladder is treatable. Let us help you regain control.

Do you have an overactive bladder?

You may have an overactive bladder if you experience:

  • Sudden, strong urges to urinate that are difficult to delay
  • Urinating more than 8 times in 24 hours
  • Waking 2 or more times at night to urinate (nocturia)
  • Urge incontinence (leaking urine when you can’t reach the toilet in time)
  • Planning your life around bathroom locations
  • Avoiding social situations due to bladder concerns
  • Rushing to the toilet to prevent accidents
  • Impact on your work, sleep, and quality of life

If this sounds familiar, it’s time for a specialist assessment.

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Common causes and risk factors

1. Bladder Muscle Overactivity

The detrusor muscle in the bladder contracts involuntarily, creating sudden, strong urges to urinate even when the bladder isn’t full.

2. Nerve Dysfunction

Problems with the nerves that control the bladder can cause overactive bladder symptoms. This can be related to neurological conditions or damage.

3. Pelvic Floor Dysfunction

Weak or tight pelvic floor muscles can contribute to urgency and urge incontinence.

4. Hormonal Changes (Menopause)

Low oestrogen levels after menopause can affect bladder control and contribute to OAB symptoms.

5. Ageing

Whilst OAB is not a normal part of ageing, it becomes more common as we get older due to changes in bladder muscle and nerve function.

6. Obesity

Excess weight puts additional pressure on the bladder and pelvic floor, worsening OAB symptoms.

7. Dietary Irritants

Caffeine, alcohol, acidic foods, and artificial sweeteners can irritate the bladder and worsen symptoms.

8. Chronic Constipation

Straining and pressure from constipation can affect bladder function.

9. Neurological Conditions

Conditions such as multiple sclerosis, Parkinson’s disease, or stroke can affect bladder control.

How we diagnose and treat an overactive bladder

Comprehensive history

We’ll discuss:

  • The nature and frequency of your urgency episodes
  • How often you urinate during the day and night
  • Whether you experience leakage
  • Fluid intake patterns and dietary habits
  • Impact on your daily life and sleep
  • Medical conditions and medications
  • Previous treatments and their effectiveness
Thorough examination

A careful examination can help:

  • Assess pelvic floor muscle function
  • Rule out pelvic organ prolapse
  • Identify signs of vaginal atrophy
Appropriate testing

When needed, we may perform:

  • Urinalysis and urine culture to rule out infection
  • Post-void residual measurement to check bladder emptying
  • Urodynamic testing (in selected cases) to assess bladder function and confirm diagnosis
Personalised treatment plan

Treatment for an overactive bladder is typically approached in stages:

  1. First-line treatments:
    • Behavioural modifications
    • Pelvic floor physiotherapy
    • Lifestyle modifications
  2. Second-line treatments:
    • Medications
  3. Third-line treatments (if first and second-line treatments are insufficient):
    • Botox injections
    • Neuromodulation

Frequently asked questions

Q: Is overactive bladder the same as stress incontinence?

A: No, they are different conditions. An overactive bladder causes urgency and urge incontinence (leaking when you can’t reach the toilet in time), whilst stress incontinence causes leaking with coughing, sneezing, or exercise. Some women have both.

Q: Will I need medication forever?

A: Not necessarily. Many women improve with behavioural modifications and pelvic floor physiotherapy alone. If medication is needed, some women can eventually reduce or stop it once symptoms are controlled.

Q: Can bladder retraining really work?

A: Yes, bladder retraining is highly effective for many women with OAB. It involves gradually increasing the time between bathroom visits to retrain the bladder to hold more urine and reduce urgency.

Q: Should I drink less water?

A: No, restricting fluids can make symptoms worse. The goal is to drink an appropriate amount (about 1.5-2 litres per day) and time your intake appropriately, avoiding large amounts before bed.

Q: Is an overactive bladder just a normal part of ageing?

A: No, whilst OAB becomes more common with age, it is not a normal part of ageing and should not be accepted as such. Effective treatments are available at any age.

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Take the first step towards bladder control

An overactive bladder doesn't have to control your life. With proper diagnosis and treatment, you can reduce urgency, decrease frequency, and regain your confidence and freedom.
Contact usBook a consultation