Gynaecology

Overactive Bladder
General Gynaecology
What is an overactive bladder?

In a normal bladder, the bladder muscle (Detrusor Muscle) contracts when you go to
the toilet to pass urine.

An overactive bladder is when the detrusor bladder muscle misbehaves and

contracts to try and squeeze urine out before the bladder is full. This may happen
without warning and sometimes you get a very sudden strong urge to go to the toilet
and you may leak urine.

What symptoms will I have?

Frequency Going to the toilet more than 8 times a day. Passing small
amounts of urine
Nocturia Being woken at night to go to the toilet more than once.
Urgency A strong need to go to the toilet.
Urge Incontinence An unwanted loss of urine which happens with a strong
need to go to the toilet. This urine loss can be a few drops or a complete
emptying of all the urine in your bladder.

These symptoms may occur when you hear or see running water, while trying to
open your front door to get to the toilet quickly, standing up, laughing and during
sexual intercourse.

How do you diagnose Overactive Bladder?

An overactive bladder can sometimes be difficult to diagnose from your symptoms.

There are several tests that can be done to help the doctors make a diagnosis. You
may not require all of these tests

What are these tests?

Urine Sample- it is necessary that we exclude a urine infection as the symptoms are
very similar

1
 Fluid input/Output Chart (Bladder Diary) You will be asked to fill this at home for
about 3-4 days. This allows the doctors to see how much fluid you drink each day,
what type of drinks you have, how often you go to the toilet and how much urine you
pass when you do go.

Cystometry (Bladder Pressure Test) This test can see what is happening to your
bladder when it is filling with fluid and emptying. It helps to decide what is causing
your symptoms (Separate leaflet available).

Ambulatory Bladder Pressure Test This test looks for the same as a Cystometry
but monitors the bladder over a longer period of time.(Separate leaflet available)
Cystoscopy This test can be done under a general or local anaesthetic. A thin
telescope (cystoscope) can look directly inside the bladder. (Separate leaflet
available)

What are the treatments for an overactive bladder?

Monitor your fluid intake. A recommended amount of fluid to drink over 24

hours is about 1.5 litres to 2 litres. This is about 6-8 cups (unless medically
indicated for you to drink more). Thirst is a more accurate amount of how
much you drink.

Do not cut back on fluids as this causes the urine to be more concentrated
and this can increase the chance of an infection. It is normal to pass volumes
of urine between 300- 400mls

You need to avoid drinks that contain caffeine and other irritants which may
aggravate your symptoms. These include coffee, tea, alcohol, cola, other fizzy/
carbonated drinks and stimulant drinks. Try drinking water, herbal or fruit
teas, decaffeinated drinks, milk, diluted fruit juice.

Bladder training. This is when you need to learn to hold on for longer periods
of time before going to the toilet. This may not work immediately, but over a
period of time, it can have very good effect if you persevere. (Separate leaflet
available)

Medical Treatments

Medication A medication known as anticholinergic can be prescribed if this is

indicated. Anticholinergics work by stopping unwanted contractions of the
bladder muscle. This then helps you to hold on for longer before you need to
2
 go to the toilet. There are different tablets available and the doctor will discuss
with you which type you will be prescribed. These tablets do have some side
effects, the most common being a dry mouth and constipation. Very often the
side effects will settle down after 2-3 weeks. It is important that you persevere
with these tablets, as your symptoms may not improve immediately. You will
need to take this medication long term and it will often take 8 weeks before the
full effect of the medication is known.

Low frequency electrical stimulation can help to calm your bladder and help
improve urgency and frequency. This treatment is done at home. You will be
loaned a kit to use every day for 3months.Further information regarding this
treatment will be given to you upon request.

Sometimes some of your other medication can cause some of your symptoms
to be worse. If you take diuretics (water tablets) they can, make you pass
more urine. Sometimes discussing this with your GP as changing the time that
you take this medication can improve your quality of life.

Botulinum Toxin (Botox) this treatment is given when all the above
treatments have not worked well and improved your symptoms and quality of
live. Botox is injected into the muscle of the bladder wall in several places and
thus allowing the bladder to become more relaxed and stretchy. This is
performed under a local anaesthetic. (Separate leaflet available)

Note

All of the above treatments will improve symptoms but they will not cure the problem
of an overactive bladder. You have to discover the best combination of treatments
that give you the best result.

If you have any questions, please do not hesitate to contact the nursing staff who
specialise in Urogynaecology and provide support to patients under this field of care;
at our Crown Street Outpatients on 0151 702 4321/4319or at our Aintree
Outpatients Department on 0151 529 2025

Useful Website

www.bladderandbowelfoundation.org

3
 This leaflet can be made available in other formats on request.

If you would like to make any suggestions or comments about the content of this
leaflet, or would like a copy in a different format please contact the Patient
Experience Team on 0151 702 4160 or e-mail

feedback@lwh.nhs.uk

Please note that Liverpool Womens NHS Foundation Trust is a smoke free site.
Smoking is not allowed inside the hospital building or within the hospital grounds, car
parks and gardens. Staff are available to give advice about stopping smoking, please
ask your nurse about this.

Ref Gyn 01.15/25 (version 4)

Issue date: 02/2015
Review date 01/2018

copyright Liverpool Womens NHS Foundation Trust