Learn more about incontinence
These articles about leaks, bedwetting and continence care are here for you regardless if you are a man, woman, carer, relative, or professional.
What is overactive bladder syndrome?
(OAB), also sometimes referred to as an ‘irritable’ or ‘sensitive’ bladder", is defined by an ongoing increase in urinary urgency. This can include waking during the night with an urgent need to pass urine – with or without incontinence – in the absence of infection or another explanation.
What are the overactive bladder symptoms?
Of the four symptoms that define overactive bladder, urinary urgency is generally the most impactful to patients. Doctors separate ‘urge’, the normal sensation to pass urine when the bladder is nearly full, with ‘urgency’, a desperate need to pass urine that cannot be ignored. Patients with have many episodes a day of feeling a desperate need to pass urine.
As well as urgency, overactive bladder is defined by increased urinary frequency during the day and waking during the night to pass urine – a condition known as Nocturia, which doesn’t involve bedwetting.
According to the NHS, it's normal to go to the toilet between four and eight times a day, and once in the night. Any more than this could indicate an overactive or irritable bladder.
The condition is more common among older adults and affects both women and men.
What causes overactive bladder symptoms?
“In many cases, we simply don’t know what causes overactive bladder in men or women,” says Professor John S. Young, Translational Healthcare Lead, Centre for Biodiscovery. Professor Young goes on to explain:
The bladder is a hollow organ that looks a little like a small balloon. The walls of the balloon are made of muscle, called the ‘detrusor’ muscle. The bladder grows to accommodate urine produced by our kidneys and during this process, the muscle relaxes, allowing the bladder to increase in size. When we pass urine, the muscle contracts to squeeze urine out of the bladder.
It used to be thought that syndrome was caused by the detrusor muscle squeezing when not necessary – something called ‘detrusor overactivity’. In the early 2000s, it was shown that detrusor overactivity does not relate especially well with overactive bladder symptoms, and we still don’t fully understand if there’s any relationship.
There are lots of theories about the causes of overactive bladder but, in most cases, it remains unclear. An exception – in about 1 in 20 cases – is when overactive bladder occurs because of another medical condition.
Conditions that can cause overactive bladder?
syndrome can be the result of several underlying diseases or conditions. This is what makes diagnosing and treating overactive bladder a challenge.
One cause could be an obstruction to the urethra (the tube through which urine leaves the body). In men this is often caused by an enlarged prostate. The is a gland in men, which is located at the base of the bladder. Often in older men, the gland starts to grow larger and can obstruct the urine tube. A symptom of this is a poor stream of urine, also known as problems emptying the bladder or incomplete emptying of the bladder.
Conditions that affect the nervous system - such as spina bifida, multiple Sclerosis and Parkinson's – can also result in overactive bladder.
Many other diseases or conditions can produce similar symptoms, and this can make it difficult to diagnose and treat overactive bladder symptoms effectively.
Overactive bladder at night
An overactive bladder at night, also known as nocturia, is a common problem, particularly as you age. One in three adults over the age of 30 need to make at least two trips to the bathroom at night.
People experiencing nocturia wake up more than once a night to go to the toilet, where most people can sleep six to eight hours without having to get up. Waking to pass urine can result in sleep loss along with other complications, as your normal sleep cycle is disrupted.
If a patient is experiencing nocturia alone, their doctor will check for this, and the treatment will be quite different to if the patient is experiencing nocturia as part of OAB symptoms.
Overactive bladder in men
Many cases of overactive bladder in men are caused by an enlarged . The prostate may get larger with age and block the flow of urine, causing symptoms. However, there are numerous other factors that may be contributing to symptoms, other than prostate problems, such as lifestyle and bladder stones, along with more serious conditions that affect the nervous system.
Overactive bladder in women
Urinary incontinence affects twice as many women as men. The two most common types being stress incontinence and overactive bladder. This is because certain life events such as pregnancy, childbirth and menopause can cause problems with the muscles and nerves that help the bladder to hold or pass urine.
44% of women say they’d feel embarrassed by developing , while feeling less attractive and more self-conscious were the next most common answers in TENA’s Age of Confidence Survey. But this needn’t be the case. Read on to learn more about treatments that are available.
Treating overactive bladder?
Treating overactive bladder can be complicated as it is often difficult to pinpoint the exact cause of the problem. Because of this, treatment often involves targeting the symptoms that are causing the most distress.
A doctor will first recommend what are known as conservative measures, such as:
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Changes to lifestyle
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Diet.
If these prove to be ineffective, medication may be the next step. If symptoms persist or become more severe, surgical procedures are available.
If you are concerned about bladder health or are experiencing an increased urgency to urinate, we suggest you first contact a healthcare professional or your GP. They will be able to offer more specific advice on the best course of treatment.
What can I do to manage overactive bladder symptoms?
Seeking medical advice from your GP is important as finding the underlying cause of symptoms can be difficult. It may take time for them to reach a diagnosis, so the sooner this process begins the better.They will then be able to help you with advice and a treatment plan to improve your condition. There are many treatment options that can help you manage the symptoms of overactive bladder, to ensure you can continue living life with confidence and freedom.
Though it may sound obvious, things like drinking too much fluid can contribute to overactive bladder symptoms. Certain drinks such as coffee or other highly caffeinated drinks may also irritate the bladder and make symptoms of overactive bladder worse.
Conversely, low fluid intake can also cause feelings of urgency. Avoiding drinking to reduce feelings of urgency can make the problem worse as urine becomes too concentrated, irritating the bladder lining and causing infection.
Dehydration also increases the risk of constipation, a factor known to increase the chances of experiencing urinary incontinence.
If you’re experiencing drips or urine leakage, TENA has a full range of pads, pants, shields and other products for both men and women. Discreet and effective, TENA products remove some of the stress caused by overactive bladder symptoms, giving you peace of mind and a fresh, dry feeling, day and night.
If you'd like to keep learning, consider trying bladder training to maintain your urinary health, or learn how to keep a bladder diary to monitor your urinary health and could aid in your diagnosis or treatment.
We’ve also recently partnered with Bladder and Bowel UK to raise further awareness of these types of issues during COVID and beyond – have a look at the partnership here.
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