What is an Overactive Bladder (OAB)?
Symptoms of urinary urgency, with increased frequency of going to the toilet during the day or night. A person may also experience leakage with urgency, but this doesn’t happen to everybody. Urgency is defined as a sudden, strong desire to void, that is difficult to defer. Urinary incontinence affects up to 10% of Australian men and up to 38% of Australian women.
Why does this happen?
We don’t exactly know why this happens. For most women, it occurs spontaneously, and can gradually worsen over time, but for others, it may have always been present, since they were a child.
What causes the symptoms?
There can be several causes for the symptoms, including:
- The muscle of the bladder wall, called the detrusor, becomes overactive. This means that the bladder muscle squeezes at times it shouldn’t!
- The nerves of the bladder wall are over-sensitive or produce abnormal signals
- The processing centres in the brain have changed – don’t worry, they can change back! Our brain is wonderfully neuroplastic like that.
- There is stress urinary incontinence which provokes the urgency
- There is decreased bladder extensibility, which can sometimes occur in older age
Is there treatment available?
YES! This is not something you have to put up with, there are many options for treatment. Usually, it starts by seeing your GP to rule out any other causes of your symptoms. Then a conservative approach is usually recommended – this is where a pelvic health physiotherapist comes in. Management could involve:
- Pelvic floor muscle training or downtraining
- Bladder retraining
- Urge suppression techniques
- Analysis and modification of your fluid intake and bladder irritants
- Transcutaneous tibial nerve stimulation – application of electrical impulses to your tibial nerve has been shown to reduce urgency and frequency in people with OAB
Your physiotherapist can help you decide what treatment approach may be best for you. Other managements beyond physiotherapy for OAB can include prescription medications, botox and sacral neuromodulation. But remember we have a Free Initial Assessment, so if you want to know more, give us a call on (08) 8296 1755 to book an assessment with me to discuss your symptoms.
Written by Fiona Burford, Women's Health Physiotherapist.