If you wee frequently (more than 8 x a day), or urgently (no warning) you may have Over Active Bladder!
Over active bladder (OAB) is defined as urinary urgency, usually with day time and / or night time (nocturia) frequency, with or without urinary urgency incontinence - also known as Overactive Bladder Dry or Overactive Bladder Wet.
So, what is it meant by urgency? Urgency is defined as a compelling need to urinate which is difficult to defer due to pain, pressure and/or discomfort. Another way to put this into perspective is a desperate desire to urinate that cannot wait.
This definition can be confusing! But OAB is a symptom based criteria, investigations such as cystometry or urodynamics can be undertaken to determine the ‘why’ behind OAB. In the clinic, physiotherapist may provided you with a bladder diary to compare your fluid input/output, leakage, and urge level. Yes, this is exactly how it sounds, measuring your fluid input and urine output - a bit of a commitment but a very informative task !
The why behind OAB may be different for each presentation. Before we dive deep, it helps to understand ‘regular’ bladder and urinary function . Urine is made by the kidneys, and then stored in the bladder until emptying or voiding occurs. There are many layers of tissue and muscle included in the bladder, one you may of heard of is called the detrusor muscle. For continence to occur, the bladder wall and muscles need to relax and expand, while the urethral and pelvic floor muscles contract, then when voiding occurs the opposite needs to happen: the bladder contracts and urethral and pelvic floor muscles relax.
OAB, may be present in men and women, transient or chronic. In some cases, overactive bladder can be due to contractions of the detrusor muscle. This contraction can cause the sensation of urinary urgency prior to complete bladder filling, however not everyone with detrusor overactivity has OAB, and not everyone with OAB has detrusor overactivity! Confusing right !? Other reasons behind overactive bladder included;
High fluid intake
Constipation causing increase pressure on the bladder
Low estrogen levels, such as during menopause and postpartum period, which may result in changes to neurotransmitters and bladder tissue distensibility
Fascia; such as bladder wall prolapse or bladder neck hypermobility
Lesions; such as endometriosis or PCOS
Depending on the ‘why’ behind OAB, treatments will vary. Treatments may include bladder deferring strategies, pelvic floor muscle training, changes to fluid intake, medication and/or surgery . Electrical stimulation either internally or externally is another treatment option. Exciting research is coming into this sphere to support stimulating the tibial nerve, yes this is a nerve in your leg, to help manage symptoms of OAB! Due to the variety of symptoms and reasons behind OAB, it is an area that requires specific and individualized treatment to get you the best results!