Polly Weston
Chair, Association for Continence Advice (ACA)
Overactive bladder (OAB) is defined as urgency that can occur with or without urge urinary incontinence and usually with frequency and nocturia (NICE 2015).
Common stories from patients with OAB suggest they “just can’t wait” and are rushing to the toilet, often wet before they get there. Patients often report they go to the toilet prior to outings “just in case”, thus worsening the issue as the bladder learns to empty more frequently. This bladder complaint often goes unreported as patients find the bothersome symptoms embarrassing to discuss.
Impact on relationships
The embarrassment of accidental bladder leakage caused by OAB can cause patients to feel socially isolated and impacts on ability to work as well as affecting personal relationships.
Treatments for OAB can include medication trials and more complex invasive botulinum toxin A injections, commonly known as bladder Botox. The recommendation for first line treatment of OAB is likely to focus on non-invasive lifestyle changes.
This bladder complaint often goes unreported as patients find the bothersome symptoms embarrassing to discuss.
Therefore, patients who have this symptom can ask their GP for a referral to their local NHS bladder and bowel service where they will be assessed by a suitably trained healthcare professional and given individual advice and support.
Lifestyle interventions
This will include an examination to confirm diagnosis, followed by some simple lifestyle changes, such as BMI and weight management advice and optimal hydration and nutrition advice specific for body sizes. It may also include constipation avoidance advice and ensuring fluid choices don’t contain stimulants that may irritate the bladder and exacerbate the symptoms, such as switching to decaffeinated and non-carbonated drinks.
Next steps, if required, will include pelvic floor muscle examination, teaching pelvic floor muscle exercises and bladder retraining to optimise bladder capacity and support the patient with bladder control.
Patients often report that this opportunity to discuss the OAB symptoms with a healthcare professional and be given some simple and achievable advice to promote self-care can build confidence and help improve their quality of life. As well as reducing the need for more invasive procedures.
