Overactive Bladder

What is Overactive Bladder?

Overactive bladder (OAB) is a continence condition where a person experiences increased urgency to urinate. Some describe it as a sudden desperate urge to empty their bladder. These people may also go to the toilet several times a day or night and they may leak urine on the way to the toilet. There is also no urinary tract infection or any other obvious pathology causing their issue.

The prevalence of OAB symptoms in the adult population is around 17%. In women this could reach 50% with increasing age.

This condition not only affects people physically, but can impact on them socially, psychologically and sexually.

How is Overactive Bladder Diagnosed?

Overactive bladder can be diagnosed if the person has the signs below and once all other pathologies have been excluded ( eg. urinary tract infection, cancer and bladder stones).

Signs of Overactive Bladder

Urinary Urgency: Increased urgency to empty your bladder
+/- Urge Urinary Incontinence: Leaking urine when feeling an urgent need to empty your bladder
+/- Increased bladder daytime frequency: Going to the toilet multiple times a day for your bladder.
+/- Increased bladder night time frequency: Going to the toilet multiple times at night for your bladder

What is the Treatment for Overactive Bladder?

If you are diagnosed with overactive bladder, the first line treatment is to trial conservative management strategies and progress from there

The following is a list of treatments for OAB from conservative management to surgery.

1. Physiotherapy (Conservative management)

Behavioural modifications
Bladder training
Education on the condition
Timed toileting strategies
Pelvic floor muscle training
Electrical stimulation (TENS machine)

2. Medications

These include oral tablets or patches
Your GP or specialist (urologist/urogynaecologist) can discuss these with you
Specialist intervention:
• This may include botox injections or tibial nerve stimulation
• Your specialist (urologist/urogynaecologist) can discuss these with you

What can a Women’s Health Physiotherapist do if you are suffering from overactive bladder?

Thorough subjective and objective assessment (current and past history)
If indicated an internal examination or real-time ultrasound of your pelvic floor muscles to see if they are contributing to your problem
Use bladder diaries and analyse the results with you to work out an individual management plan.
Anyone of the following treatment strategies maybe implemented depending on your individual needs.
Behavioural modifications
Bladder training
Education on the condition
Timed toileting strategies
Pelvic floor muscle training
Electrical stimulation (TENS machine)
If required liaise with your GP or specialist