Overactive bladder

What is an overactive bladder?

When your bladder is full, it squeezes (contracts) so you can wee. With normal bladder function, you can usually hold on until you get to the toilet. With an overactive bladder, you need to wee before your bladder is full.

Symptoms

If you have an overactive bladder, you may:

• need to wee often or urgently, or both
• find it hard to hold on until you get to the toilet
• leak wee before you get to the toilet
• wee more than seven times each day
• wake up more than once in the night to wee
• leak wee while asleep.

Causes

An overactive bladder may be caused by:

• neurological disorders (e.g. stroke, multiple sclerosis, Parkinson’s disease, spina bifida or dementia)
• diabetes that’s not well managed
• the bladder not emptying fully
• bladder outlet blockages (e.g. due to prolapse or surgery)
• past pelvic cancer treatment.

It can also be caused by:

• hormonal changes due to menopause
• new medicines (e.g. fluid tablets)
• smoking
• drinking too much fluid (i.e. more than three litres per day)
• drinking too many caffeinated, fizzy or alcoholic drinks.

Other risk factors include obesity and chronic constipation.

Diagnosis

To diagnose overactive bladder, your doctor will ask about your medical history and symptoms. They will also get a urine sample to rule out urinary infections and will ask to do a pelvic examination to find the cause of the problem.

If you are referred to a specialist, you may also need to do:

• bladder function tests
• pelvic or kidney ultrasounds, or both
• tests to check for neurological disorders.

Treatment and management

A pelvic floor physiotherapist can help you to manage an overactive bladder. You will learn helpful techniques like how to empty your bladder fully and reduce the urgent need to wee.

Bladder training

You can learn bladder training under the guidance of a pelvic floor physiotherapist. Bladder training teaches you bladder calming techniques so you can have more wee in your bladder without feeling an urgent need to go to the toilet. Pelvic floor exercises can also help you reduce the urgent need to wee.

A bladder diary can help you keep track of how your bladder works.

Visit the Continence Foundation Australia website to learn more about bladder training.

What you can do

There are other things you can do to treat an overactive bladder. For example:

• drink about 1.5 to 2 litres of fluid (preferably water) per day
• reduce caffeine, alcohol, citrus juices and fizzy drinks, including soft drinks and soda water
• reduce artificial sweeteners
• maintain a healthy weight
• quit smoking
• try to avoid constipation by increasing fibre, drinking enough fluids and having good bowel habits.

In postmenopausal women, topical vaginal oestrogen may help by improving the blood flow and skin in the vagina, bladder and urethra.