Overactive Bladder (OAB) is a common condition where the bladder muscles contract involuntarily, causing sudden urges to urinate that may be hard to control. It is not a normal part of aging and can often be improved with treatment.
Common symptoms
- Urgency: Sudden, intense need to urinate (even with little urine).
- Frequency: Urinating ≥8 times/day.
- Nocturia: Waking ≥2 times/night to urinate.
- Urge incontinence: Leaking urine after an urgent need.
Causes & triggers
OAB develops when bladder nerves or muscles malfunction. Contributing factors:
- Age-related changes: Weakened pelvic muscles.
- Nerve damage: From childbirth, diabetes, or back surgery.
- Menopause: Low oestrogen thins urethral/bladder tissues.
- Lifestyle triggers:
Caffeine, alcohol, carbonated drinks, Artificial sweeteners, Constipation and Chronic UTIs.
Diagnosis
Your doctor may recommend:
- Bladder diary: Track fluid intake/voiding/leaks for 3 days.
- Urine tests: Rule out infection or blood.
- Ultrasound: Check residual urine after voiding.
- Urodynamic testing: Measures bladder pressure (if needed).
Management & Treatment
Lifestyle & behavioural strategies
| Do | Avoid |
| Scheduled voiding (every 2–3 hours) | Caffeine, alcohol, soda |
| Double voiding (urinate twice) | Artificial sweeteners |
| Pelvic floor exercises (Kegels) | Drinking >2L fluid after 6 PM |
| Maintain healthy weight | Constipation (eat high-fibre foods) |
Pelvic floor physiotherapy
- Strengthens pelvic muscles via biofeedback or electrical stimulation.
- Reduces urgency/incontinence in 70–80% of women.
Medications
| Drug Class | Examples | Key Considerations |
| Anticholinergics | Oxybutynin, Solifenacin | Dry mouth, constipation |
| Beta-3 agonists | Mirabegron | May raise blood pressure |
Advanced Therapies
- Botox injections: Relaxes bladder muscles (lasts 6–9 months).
- Nerve stimulation:
- Percutaneous Tibial Nerve Stimulation (PTNS): Weekly clinic sessions.
- Sacral Neuromodulation: Implanted device for severe cases.
eGynaecologist Advice
- You should start a bladder diary to identify pattern and triggers if you suspect OAB but ensure you differentiate it from urgent conditions like UTI.
- You should seek gynaecological consultation for comprehensive treatment as menopause, childbirth and pelvic floor dynamics influence this condition and may need long-term support.
Frequently Asked Questions
Is OAB just part of getting older?
No – it’s a treatable medical condition unrelated to age and 1 in 3 women under 65 experience OAB.
Can Kegels really help?
Yes! Properly done (squeezing pelvic muscles 10 sec, 10x/day), they reduce leaks by 50–80%. Electro-magnetic stimulation by EmSella treatment has very high patient satisfaction rate.
Will I need medication forever?
Not always. Many women reduce doses after 6–12 months as bladder retraining takes effect.
Does OAB affect sex?
Urgency/leaks may cause anxiety. Pelvic floor therapy including EmSella treatment often improves intimacy.
Are there surgical options?
Rarely (e.g., bladder augmentation). Nerve stimulation or Botox are preferred first.
