Continence matters: Part two
Continuing from part one of our Continence Series, let’s delve into the topic of an overactive bladder discussing its symptoms, symptoms management and treatment options.
What is an overactive bladder?
Our bladder, also known as detrusor muscle, is a hollow muscular organ that acts as a reservoir for your urine, when full the muscle will contract to release urine.
An overactive bladder refers to when your bladder contracts before it is full, sometimes contracting when you are not ready.
What are the symptoms of an overactive bladder?
Urinary urgency is the main symptom of an overactive bladder, it is an immediate feeling to use the toilet. It can be sudden, strong and hard to hold in.
You may go to the toilet often and find it hard to hold it in before you get to the toilet. At times, you may leak urine on the way to the toilet.
Factors that can affect urinary urgency includes:
- Irritated bladder
- Consumption of caffeine or alcohol
- Not drinking enough fluid, leading to having strong, dark urine
- Bladder infections and constipations
- Having a neurological condition
How is urinary urgency measured?
Urinary urgency can be graded on a scale from 0-4.
| Urinary Urgency | Description | |
|---|---|---|
| 0 | No urgency | I felt no need to empty. I emptied for other reasons. |
| 1 | Mild urgency | I could put it off as long as needed. I had no fear of wetting myself. |
| 2 | Moderate urgency | I could put it off for a short time. I had no fear of wetting myself. |
| 3 | Severe urgency | I could not put it off. I had to rush to the toilet. I feared I would wet myself. |
| 4 | Urge incontinence | I leaked before I could get to the toilet. |
How to manage an overactive bladder
Drinking well
Drinking plenty of fluids can help alleviate an overactive bladder. Fluids can include milk, juice and soup, however water is the best! Try to cut down on caffeine and alcohol consumption as this may upset your bladder. Look out for consuming coffee, tea, chocolate flavoured beverages and fizzy drinks such as sparkling water, cola and energy sports drink, as these all contain caffeine.
Eating well
Eat plenty of vegetables, fruit, legumes (beans), grains, nuts and seeds every day. This will increase your fibre intake and help you go to the toilet regularly. It is also important to drink plenty of water when increasing fibre in your diet to prevent constipation, which can cause urinary infections and urgency. It’s a delicate balance and you can reach out to the MSWA Dietetics team to assist you in making choices regarding your diet.
Live a healthy lifestyle
Keep active! Exercising regularly will help to regulate your bowels. It is recommended to do at least 30 minutes of exercise, or what is recommended by your doctor or MSWA Continence Physiotherapist. Simple physical activity such as brisk walking can help keep your bowel regular. Quitting smoking can lead to reduction in overactive bladder symptoms. Eliminating alcohol intake can greatly reduce the symptoms from urge incontinence.
Look after your pelvic floor muscles
The pelvic floor muscles give you the ability to control the release of urine, faeces and to delay emptying until it is convenient. Like any muscle of the body, pelvic floor muscles can be trained with regular, targeted exercise. Try to avoid putting extra strain on the pelvic floor muscles when using the toilet. Consult a pelvic health physiotherapist or nurse continence specialist on how you can exercise your pelvic floor muscles the right way.
Practice good toilet habits
Practising good toilet habits helps improve bladder and bowel health. It is normal to use the restroom four to six times a day, and you shouldn’t have to wake up multiple times in the night to empty your bladder.
Good toilet habits include:
- Try to go to the toilet only when your bladder is full.
- Do not go to the toilet ‘just in case’ – only go when you need to.
- Take your time and relax when you are on the toilet. This helps your bladder to empty out fully. If you rush this process, you may not empty your bladder fully and over time you could get a bladder infection.
- When emptying your bowels, do not strain your bowels. This puts extra pressure onto your pelvic floor muscles and may weaken the muscles.
- Use the correct sitting position on the toilet – sit on the toilet, place your elbows on your knees and lean forward. Do not hover over the toilet seat.
Seek help
If you experience any urinary incontinence, whether it is an overactive bladder or any of the symptoms listed above, it is important to seek help. Reach out to a continence nurse specialist, pelvic health physiotherapists, or your local GP.
Seek help from your continence nurse specialist (MSWA), pelvic health physiotherapist (MSWA), and doctor (GP, Neurologist).
Treatment for overactive bladder
Behavioural therapy is often the first method employed to help manage an overactive bladder. It is highly effective with minimal side effects.
This includes:
- Bladder training
- Healthy weight
- Intermittent catheterisation
- Pelvic floor muscles exercises
Medications can relax the bladder and relieve symptoms of an overactive bladder, reducing episodes of urge incontinence. Consult your doctor to prescribe the right medication for you, it is available in various forms including via a pill, skin patch or a gel.
Consider botox injections if necessary. Your doctor can inject this neurotoxin into your bladder to temporarily stop it from contracting too much, relaxing the muscle and increasing the amount of urine the bladder can hold.
Nerve stimulation involves sending mild electrical pulses to specific nerves to improve overactive bladder symptoms. Similar to how a pacemaker functions for your heart! The two methods that can help with overactive bladders are sacral nerve stimulation and the percutaneous tibial nerve stimulation.
For the next part of our Continence Series, we will focus on the underactive bladder.
Where to find more information:
Continence Foundation of Australia provides free, confidential information and advice regarding incontinence issues and can also direct you to local services.
1800 33 00 66 (Monday-Friday, 8am-8pm AEST).
