Overactive Bladder

Overactive Bladder


This is a common condition affecting women and men, which can have a significant impact on a patient’s (and partner’s) quality of life. Symptoms include the need to rush to pass urine, going to pass urine often, needing to get up at night to pass urine and  urine leakage. It is caused by the bladder muscle contracting too readily.



What Causes Overactive Bladder?

Whilst the cause of OAB is unknown, it is important to exclude a underlying cause, and investigations may be necessary.  This a urine test to rule out infection or the presence of abnormal cells, an scan of the bladder, a flow. It is often helpful to complete a a bladder diary and in men a questionnaire.. Some patients may require an internal inspection of their bladder with a flexible cystoscopy.


In some patients, there is an identifiable underlying cause. These can include nerve damage or neurological disease such as multiple sclerosis, Parkinson’s disease, or stroke, in which case the diagnosis is called neurogenic detrusor overactivity. More significant underlying causes which need to be ruled out include bladder cancer, urinary tract infections (see above) and benign prostatic hyperplasia.



How is Overactive Bladder Treated?

OAB is usually treated in a step-wise fashion, starting with the most straightforward, least invasive treatment first, and only moving on to more complex treatments. Treatments include behavioural therapies, drugs (anticholinergic medication), with injection of botox (botulinum toxin) into the bladder muscle, electrical stimulation of the bladder (neuromodulation).


Lifestyle changes and bladder retraining have been shown to improve symptoms. Certain drugs can inhibit the contraction of the bladder muscle. They are usually called antimuscarinics, and they include: oxybutynin, tolterodine, and solefenacin. They may improve symptoms for a number of patients but may have side effects including a dry mouth and constipation. Mirabegron which is Beta 3 agonist also reduces the contraction of the bladder effectively.