Overactive Bladder

Overactive bladder (OAB) is the name for a group of urinary symptoms.
These symptoms include:
• Feeling a sudden urge to urinate that’s difficult to control
• Urge incontinence — the involuntary loss of urine immediately following the urgent feeling of needing to urinate
• Urinating frequently, usually eight or more times in 24 hours
• Waking up two or more times in the night to urinate (nocturia)

The bladder is a muscular sac which stores urine. With a healthy bladder, signals in your brain let you know that your bladder is getting full. Once in a convenient place the brain coordinates the relaxation of the pelvic floor muscles and the muscles of the urethra (urinary sphincter muscles), along with the bladder contracting, resulting in urination.
OAB occurs when the muscles of the bladder start to contract involuntarily even when the volume of urine in your bladder is low. This involuntary contraction creates the urgent need to urinate.

There are a number of life-style changes you can make to help your symptoms.

1. Avoid drinks and food that may irritate the bladder. Some food and drinks that may affect your bladder are:  Coffee/caffeine, Tea, Alcohol, Soda and other fizzy drinks, Some citrus fruits, Tomato-based foods, Chocolate (not white chocolate), Some spicy foods
2. Ensure you are drinking enough water. Try to drink at least 6-8 glasses of water a day
3. Avoid constipation. Persistent straining can weaken the pelvic floor muscles
4. Keep good toilet habits. Avoid going to the toilet ‘just in case’ as this tends to result in the bladder becoming more sensitive and wanting to hold smaller amounts of urine. Try to only go to the toilet when your bladder is full and you need to go. Take your time when urinating so that your bladder has an opportunity to empty completely. If you rush, this may result in your bladder not being completely empty and may lead to possible urinary infections.
5. Keep a bladder diary. Monitoring how much you drink, the volume and timings of when you pass urine and if you leak urine can help find any patterns in your behaviour or relationships to certain foods or drinks. This bladder diary is also very helpful for you GP or physiotherapist to see.
6. Maintain a healthy weight.
7. Get regular, daily physical activity and exercise.
8. Quit smoking.
9. Manage chronic conditions, such as diabetes, that might contribute to overactive bladder symptoms
   If you have symptoms of OAB see your GP. Your doctor will check to make sure that you don’t have an infection or blood in your urine. Your doctor may order a simple urodynamic test to assess the function of your bladder and its ability to empty steadily and completely. Sometimes medication is needed for OAB to calm the overactive bladder muscles.

A women’s health physiotherapist can help you reduce the symptoms of OAB. After taking a thorough history from you and examining the pelvic floor they will help you with Bladder retraining and strengthening your pelvic floor if needed.
Bladder re-training helps to increase the time between each visit to the toilet by holding on for as long as possible before you go. This will seem difficult at first and they will help you to work slowly on improving your ‘hold’ time. When trying to hold-on, distracting yourself is very useful. Try saying the alphabet backwards, sing a song or remember your times tables! Contracting your pelvic floor muscles can also help to desensitise the bladder and help control the desperate need to go. With time, it should become easier as the bladder becomes used to holding larger amounts of urine. The idea is to gradually extend the time between toilet trips and to train your bladder to stretch more easily. It may take several weeks to reach the target of passing urine only five to six times in 24 hours.
If you have OAB, you may feel embarrassed, isolate yourself, or limit your work and social life. Please don’t suffer in silence. Seek advice and help from your GP or a women’s health physiotherapist.