Bladder > Bladder Problems > Overactive Bladder

Overactive Bladder

If you get sudden urges to go to the toilet which are difficult to ignore, you could be suffering from an overactive bladder. This is sometimes called an unstable or irritable bladder or detrusor overactivity. It means that your bladder wants to squeeze out urine, even if it not full. The most common symptoms are listed below:

• A sudden urge to go to the toilet - Urgency
• Not getting to the toilet in time and having an accident - Urge incontinence
• Needing to go to the toilet very often (more than 7 times a day) - Frequency
• Getting up to go to the toilet during the night - Nocturia
• Wetting the bed - Nocturnal enuresis

Remember - an overactive bladder is not an inevitable part of ageing

What causes an overactive bladder?

It is often hard to say what causes an overactive bladder. Doctors recognise several underlying causes and it is important to make sure that there is no other treatable problem causing your symptoms before you assume that your problem is due to an overactive bladder. We do know that some things can irritate the bladder and make symptoms worse.

Some fluids we drink may cause problems. Caffeine and alcohol may irritate the bladder and cause urgency and frequency. Some fizzy drinks and fruit teas containing hibiscus can also irritate the bladder. On the other hand, some people do not drink enough fluids, their urine becomes very concentrated and this can also irritate the bladder.

Another common cause of urgency is an infection. Your doctor or practice nurse can do a simple urine dipstick test to see if there is an infection present.

Overactive bladder symptoms can be caused by a number of other conditions:

• People who have diabetes can develop an overactive bladder.
• Men with prostate problems.
• Women who have had operations for stress incontinence are also at risk.
• Any condition that affects the nervous system can cause problems. Stroke, Multiple Sclerosis, Parkinson's Disease and Alzheimer's are all possible causes. Some of these conditions can also cause problems getting around so that people affected may not be able to get to the toilet quickly enough.

For many people suffering from an overactive bladder, the actual cause can not be identified. It can be a relief to know that there is no other health problem causing your symptoms but it can also be frustrating and confusing not having a reason for the problem.

Finding help

If you are concerned about your symptoms and it is starting to affect your day to day life make an appointment to see your doctor, continence nurse or specialist physiotherapist. A continence nurse and specialist physiotherapist are healthcare professionals who specialise in bladder and bowel problems. You can also call our helpline on 0845 345 0165 (24 hour answerphone) for medical advice, or visit our Continence Clinic Database service to find out where your nearest clinic is, or call our general enquiries line on 01536 533255 for more information.

Once you have made an appointment, your doctor or nurse will assess you. They may ask you some of the following questions:

1. How often do you go to the toilet?
2. How often do you leak or have an accident?
3. When do you leak or have accidents?
4. What medication do you take?
5. What do you normally eat or drink?
6. Is it painful / uncomfortable when you go to the toilet?
7. How many times do you get up at night?
8. Do you ever wet the bed?

Tests

There are some tests that your doctor or healthcare professional may recommend that you have done:

Bladder diary - this takes various forms but usually you will be asked to record the times when you pass urine and how much, if you are incontinent, or if you have urgency. It is a good idea to keep this diary for a period of at least three days.

Urinalysis - this test just needs a sample of urine to find out if there is any infection, or any blood in your urine.

Residual urine - this is to find out if there is any urine left in your bladder after you have gone to the toilet. If you have problems emptying your bladder the doctor will check residual urine using an ultrasound machine to take a scan of your bladder. Another way to check is to insert a catheter into the bladder through the urethra. This shouldn't hurt but may be a bit uncomfortable.

Internal examination - the doctor / continence advisor / specialist physiotherapist puts their finger into the vagina (for women) or back passage (for men) and asks you to squeeze your muscles. This can show how strong the pelvic floor muscles are working. For men, this can detect if the size of the prostate gland.

Cystometry - this test can help find out the cause of bladder problems (women should not need this test before non-surgical treatments). It involves putting a thin catheter (a small, soft plastic tube) into the bladder through the urethra and another into the rectum through the anus. This can be a bit uncomfortable but the catheter is removed as soon as the test is over. This test is only carried out in special hospital units.

The urgent need to use the toilet or not being able to hold on can be a real problem for millions of people of all ages. If you have an overactive bladder, you are certainly not alone. Please use the link boxes below to find out about treatment and product options to help you manage your symptoms.