Do you have an overactive bladder?
Sure, being active is great, but there’s one particular part of our body we don’t want to become too active – our bladder.
An estimated 12% of Australians have a condition called overactive bladder, which can be the cause of much upheaval and distress in a person’s life. People with overactive bladders are known to have less work productivity, less sexual satisfaction, higher rates of depression and poorer sleep. Affected males have more erectile dysfunction and postmenopausal women with overactive bladders have a higher risk of falling and sustaining bone fractures.
What is overactive bladder?
Your bladder is like a muscular balloon, which contracts to empty its contents when full. Overactive bladders contract involuntarily and unexpectedly, often due to problems with the neural connection to the bladder, or as the result of an obstruction such as an enlarged prostate. Sometimes there are no known causes.
The main symptoms of overactive bladder include:
- Having to urinate urgently (whether or not you’ve been drinking or have just been to the toilet).
- Having to urinate more than about eight times over a 24-hour period.
- Waking up more than two times overnight to urinate.
- Leaking or wetting yourself before you reach the toilet on time.
What can I do about it?
Preventing the condition may be difficult, but symptoms can be reduced by adopting a few lifestyle changes.
- Regulate your fluid intake
Regulate your fluid intake so you’re drinking the correct volume for your body size and activity level. Too much fluid can overfill your bladder and too little fluid can concentrate the urine, which irritates the bladder and makes it want to empty before it’s full. (A good guide is urine colour, which should be pale lemon). Drink at the right times and schedule your fluid intake so you drink well in advance of going to bed, appointments or outings. - Limit alcohol and caffeine-based drinks
Alcohol, caffeine and fizzy drinks are known to irritate the bladder, which exacerbates symptoms of overactive bladder. Alcohol also has a diuretic effect, which can cause more frequent urination. - Avoid constipation
Constipation can trigger or worsen symptoms of overactive bladder. Not only is the bladder’s space in the abdomen restricted as a result, straining on the toilet can weaken the pelvic floor. Take every measure to avoid constipation, such as eating a fibre-rich diet, exercising regularly and responding immediately to your body’s signal to defecate. - Keep your weight in the healthy range
There is evidence that losing weight decreases the severity and frequency of symptoms of overactive bladder.
Effective, drug-free treatment programs
There are two non-invasive and drug-free treatment programs effective in alleviating the symptoms of overactive bladder (after possible causes such as prolapse, spinal damage, enlarged prostate and medications have been ruled out): pelvic floor training and bladder training.
Pelvic floor training.
Your continence professional can show you how to strengthen and train your pelvic floor muscles so they’re better equipped to control urinary leakage and reduce the impact of involuntary contractions of the bladder.
Bladder training
Your also learn to train your bladder to hold more urine and empty less often by scheduling longer toileting breaks and using distraction techniques to “hold on” for longer.
For more information, or to locate your nearest continence professional, phone the free National Continence Helpline (1800 33 00 66), which is staffed by continence health nurses 8am to 8pm weekdays. Go to continence.org.au for more information.
(Source: Continence Foundation of Australia)
References
- Irwin DE, Milsom I, Hunskaar S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 2006;50:1306–14; discussion 1314–5. Available from: [Abstract]
- Stewart WF, Van Rooven JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol 2003;20:327–36. Available from: [Abstract]
- Coyne KS, Sexton CC, Irwin DE, Kopp ZS, Kelleher CJ, Milsom I. The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study. BJU Int 2008;101:1388–95. Available from: [Abstract]
- Chapple C, Gormley EA. Developments in pharmacological therapy for the overactive bladder. BJU Int 2006;98(1 Suppl):78–87. Available from: [Abstract]
- Abrams P, Andersson KE. Muscarinic receptor antagonists for overactive bladder. BJU Int 2007;100:987–1006. Available from: [Abstract]
- Burgio KL. Current perspectives on management of urgency using bladder and behavioural training. J Am Acad Nurse Pract 2004;16(10 Suppl):4–7. Available from: [Abstract]
- Markland AD, Vaughan CP, Johnson TM 2nd, Burgio KL, Goode PS. Incontinence. Med Clin North Am 2011;95:539–54. Available from: [Abstract]
- Ghei M, Miller R, Malone-Lee J. Case series data to encourage randomized trials of bladder retraining compared to antimuscarinic agents. J Urol 2006;175:1411–6. Available from: [Abstract]
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