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Overactive bladder signs, symptoms and treatments

Having an overactive bladder is quite common. This is why it is important to be aware of the various overactive bladder signs, symptoms and treatments. Mainly, people with the condition have to go to the toilet very frequently and urgently. Sometimes, they also experience urge incontinence, which means they leak urine as well. The condition is fully treatable and even curable, usually through bladder training and/or medication.

Overactive Bladder Signs, Symptoms and Treatments:

People with this condition experience sudden feelings of urgently needing to pass urine. They also have to go to the toilet more regularly. It is caused by the bladder suddenly contracting, even when it isn’t full. There is no discernible cause, such as an enlarged prostate or urine infection, for it. The condition is also known as detrusor instability or irritable bladder.

The main signs and symptoms include:

  • – Urgency – needing to go suddenly and urgently

  • – Frequency – needing to go more than seven times daily

  • – Nocturia – waking up due to needing the toilet

  • – Urge incontinence – passing urine before making it to the toilet

It is believed that around 1 in 6 adults experience the signs and symptoms in overactive bladder signs, symptoms and treatments. The severity varies. However, around one in three people who have the condition also experience urge incontinence.

It isn’t quite understood what causes the condition. Usually, the detrusor, which is the muscle of the bladder, is relaxed when the bladder is empty. Once it is half full, most people will feel like they need the toilet, but they can hold on for a while, until they find a toilet. People with an overactive bladder, however, feel as if their bladder is completely full and cannot wait to pass urine. Most of the time, there is no cause although, sometimes, it occurs after a stroke or spinal cord injury. It is also more common in people with multiple sclerosis (MS) and in those with Parkinson’s disease.

People with the condition find that stress usually makes it worse. Furthermore, certain drinks, and particularly caffeinated drinks, have an impact. Urine infections and bladder stones can also make the condition worse.

Also, similar symptoms may occur if you have a urine infection or a stone in your bladder.

Treating Overactive Bladder Syndrome:

The main treatment for the condition is bladder treatment. Around 50% of people find that this resolves it. Pelvic floor exercises can also help. Sometimes, however, medication is required. The start of treatment, however, is usually to make lifestyle changes, including:

  • Always knowing where the nearest toilet is and making adaptations in a home if you are disabled and find it difficult to reach the toilet.

  • Avoiding caffeine, as this has a diuretic effect. Some people find that limiting their caffeine intake fully resolves the condition.

  • Avoiding alcohol. Although the link is not understood, some people find that alcohol makes the condition worse. Not drinking alcohol for a week should tell you whether or not this is the case with you.

  • Drinking fluids regularly. There is a risk of people getting dehydrated in an effort to stop their bladder from filling up.

  • Going to the toilet when needed, not whenever it feels like there is something in the bladder. Going all the time may teach the detrusor to contract even more regularly.

  • Losing weight if appropriate. A 5% to 10% drop in weight can have a significant impact.

The Bladder Drill:

If someone is diagnosed with overactive bladder, they will be shown the bladder drill. This is an exercise whereby the bladder is slowly stretched, thereby enabling it to hold more urine. Over time, the detrusor will become less overactive, increasing bladder control. Urine leaks also become less likely. The bladder drill includes:

  1. Keeping a diary of every moment urine was passed and how much urine was passed, for which you will need a measuring jug. Any urine incontinence should also be noted in this. Physicians may have charts to help you keep your diary.

  2. Going to the toilet normally for the first two or three days. This provides the baseline measurement to show how often you go, and how much you pass. You may go as often as once an hour and pass as little as 100ml.

  3. Once you have measured your baseline, you will need to try to go as little as possible. This is quite hard, but you can distract yourself by doing pelvic floor exercises, counting backwards from 100, or sitting straight on a hard seat. The aim is to eventually get to only going to the toilet every three to four hours, passing around 250ml each time.

The bladder drill is quite difficult to complete, but it gets progressively easier. You should receive plenty of support and advice from a doctor, nurse, or incontinence advisor. Do make sure that you drink as normal so as not to dehydrate.

Overactive Bladder Medication:

If the bladder drill was not effective, or not effective enough, you may be prescribed medication. These are antimuscarinics or anticholinergics. This type of medication blocks the bladder from receiving nerve impulses, thereby relaxing it and increasing its capacity. Medication is not always effective, and how effective it is also varies from one person to the next. Medication alone is rarely a full cure for overactive bladder, however. Most of the time, it is a support for the bladder drill.

Medication also comes with side effects, although these are tolerable and minor. They include constipation, dry eyes, and blurry vision. If you experience more complex side effects, you should switch medication.

Mirabegron is also sometimes prescribed. This relaxes the muscle of the bladder. It has significant side effects, however, including diarrhea, constipation, sore throat, sneezing, blocked nose, and raised blood pressure. Hence, it is rarely prescribed.

Pelvic Floor Exercises:

It is quite common for people with an overactive bladder to also experience stress incontinence. This is usually treated through pelvic floor exercises. This means strengthening the muscles around the rectum, uterus (womb), and bladder. Few people find that pelvic floor exercises are beneficial for overactive bladder alone.


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