If you have an overactive bladder (or OAB) you may feel a frequent and sudden urge to urinate. You may need to pee many times during day and night, and sometimes this urge may be difficult to control. All of these symptoms could seriously affect your quality of life, limiting your professional and social commitments.
Below you will find brief information on overactive bladder: what are the main causes, how it is diagnosed and how you can get your symptoms under control.
An overactive bladder may cause you to:
- feel a sudden urge to urinate;
- feel unable to control your bladder (urgency incontinence);
- need to urinate frequently (8 times or more during a 24h period);
- wake up several times during night needing to pee (nocturia)
In a healthy bladder, the amount of urine regulates our need to urinate. Once the bladder is full, it sends the signal to our brain that it is time to look for a toilet. In an overactive bladder, the muscles in the bladder wall start contracting involuntarily, regardless of urine volume being low. These contractions create the urgency, which can also result in incontinence.
The specific cause for this condition is still unknown. However, several conditions and circumstances have been identified as contributing factors:
- Neurological disorders
- Excess consumption of caffeine or alcohol
- Incomplete bladder emptying
- Declining cognitive function, etc.
Overactive Bladder Syndrome is diagnosed by exclusion. This means that the doctor will first exclude all other possible conditions before reaching this diagnosis. Unfortunately, overlapping symptoms often complicate the diagnostic process.
- Perform a physical exam
- Test your urine for infection or traces of blood
- Check for any sensory problems or abnormal reflexes
Your doctor may also test your bladder function through urodynamic tests. These tests check if your bladder empties completely and efficiently.
Several treatment options are available, however your first recommendation will likely be behavioural changes, as they often give positive results with no side effects. These behavioural interventions may include:
Kegel's or pelvic floor muscle exercises. Your GP or urology team can explain to you how to do these properly; or watch this video for at-home training.
- Bladder training (ie. setting a schedule for going to the toilet, and delaying voiding when you feel the urge).
- Losing weight.
- Wearing sanitary pads, to prevent embarrassing mishaps.
- Intermittent catheterisation, in case you cannot empty your bladder fully. Your urology team can teach you how to self-catheterise.
- medications (most commonly used are anticholinergics; these can be efficient, but unfortunately they often cause unpleasant side effects, such as mouth dryness and constipation);
- bladder instillation (Gepan has been clinically proven to be as effective as tolterodine, an oral drug, but without the side effects - more details below);
- Botox bladder injections (small doses of Botox injected into the bladder relax the muscles and can relieve urge; the effect is temporary and injections need to be repeated. Side effects include UTIs and urinary retention);
- Neural stimulation (regulates the nerve impulses sent to your bladder, which can reduce the sense of urgency);
- Surgery (to increase bladder capacity, or to remove it altogether).
How can Gepan help?
Gepan has been clinically proven to reduce nocturia (or nighttime urination), frequency, urge and incontinence, while increasing urine output volume*.
Furthermore, when compared to routinely used oral treatment for OAB (tolterodine tartrate), Gepan created “a more sustained improvement or cure of the symptoms”. Even after a whole year of not receiving therapy, 56% of Gepan patients still felt the improvement, compared to only 12% of patients on tolterodine.*
Mr Ahsanul Haq, Consultant Urological Surgeon and Clinical Director of Urology at Lancashire Teaching Hospital, said:
“The use of Gepan for OAB is not yet widespread but clinical data is promising. I’ve found instillations to be useful in patients who fail on oral therapies. Further research would be worthwhile but since instillations are available, well tolerated,and potentially more effective than anticholinergics, they are a good option.”