Overactive Bladder Syndrome

What is overactive bladder syndrome?

Overactive bladder syndrome, also called OAB, is common and sometimes called an irritable bladder or detrusor instability (detrusor is the medical name for the bladder muscle.). An overactive bladder is when the bladder contracts suddenly without you having control, and when the bladder is not full. Overactive bladder syndrome is a common condition where no cause can be found for the repeated and uncontrolled bladder contractions (e.g. it is not due to a urine infection or an enlarged prostate gland).

What are the symptoms?

• Sudden urgent desire to pass urine, you are not able to put off going to the toilet
• Going to the toilet often – more than seven times a day
• Waking up during the night to go to the toilet more than once at night
• Incontinence, i.e. a leaking of urine before you can get to the toilet

What causes overactive bladder syndrome?

The cause is not fully understood. However, symptoms may be made worse by stress, caffeine and alcohol.

In some cases, symptoms of an overactive bladder develop as a complication of a nerve or brain-related disease such as following a stroke, Parkinson’s disease, multiple sclerosis or after spinal cord injury. Also, similar symptoms may occur if you have a urine infection or a stone in your bladder. These conditions are not classed as overactive bladder syndrome as they have a known cause.

What are the treatments?

• Some general lifestyle measures may help e.g. avoiding caffeine and alcohol, drinking normal quantities of fluids and only going to the toilet when you need to
• Bladder training is the main treatment and can work well in up to half of cases
• Medication may be advised instead of, or in addition to, bladder training
• Pelvic floor exercises may also be advised in some cases

If the above treatments are not successful, surgery is sometimes suggested to treat overactive bladder syndrome.

What are the surgical procedures available?

• Sacral nerve stimulation – overactivity of the bladder muscle may be helped by inserting an implant into your bladder to help it contract more evenly and normally.
• Augmentation cystoplasty – a small piece of tissue from the intestine is added to the wall of the bladder to increase the size of the bladder. However, not all people can pass urine normally after this operation. You may need to insert a catheter (a small tube) into your bladder in order to empty it.
• Urinary diversion – the ureters (the tubes from the kidneys to the bladder) are routed directly to the outside of your body. This procedure is only done if all other options have failed to treat your overactive bladder syndrome.