Overactive bladder

Keisha Shakespeare-Blackmore, Staff Reporter

Are you jolted out of your sleep more than once for the night due to the urge to urinate? Or do you find that you always need to go with great urgency? Then you might be suffering from overactive bladder (OAB).

OAB is defined as urinary urgency with or without incontinence (involuntary loss) of urine. This occurs in the absence of other secondary causes such as a bladder infection, diabetes or fibroids compressing the bladder. In the past, OAB was considered an 'old people' ailment, but it affects both men and women of all ages. According to research, this condition affects people under the age of 65.

Some will say that frequent urination is a result of drinking too much water, which obstetrician and gynaecologist Dr Keisha Buchanan agrees with to some extent. She noted that the normal average daily consumption of water, including the amount we get from food, is three litres (3,000 millilitres) per day and the average urine passed is 1.5 millilitres (1,500 litres) per day.

Dr Buchanan notes that drinking water in excess of three litres can increase the frequency of urination.

"Increased fluid consumption around bedtime can result in a person getting up more than once per night. However, if the quantity of water consumed is less than three litres, and there is still increased urinary frequency, this may be abnormal," said Dr Buchanan.

Other causes

She also pointed out that there are other causes for OAB such as caffeinated beverages, cigarette smoking and medication such as diuretics. These, she said, may make an overactive bladder worse. Also, a cold environment can cause increased urination as persons sweat less in cold environments and the toxins are instead excreted in the urine.

Some of the symptoms of OAB to look out for are: sudden compelling urge to urinate; increased frequency of urination (more than four times daily or more than once during the night); and involuntary loss of urine.

"This may occur and cause embarrassment. At times, persons may feel the urge to urinate and no urine flows if the bladder is not full enough."

Other symptoms include abnormal urine colour. She said if the urine has a blue or orange colour, this may be due to the diet or medications. Cloudy urine is often a sign of a bladder infection (Note that blood in the urine may be a sign of bladder infection or tumour).

But once you have been confirmed as having OAB, there are treatment methods that you can take, such as:

1. Behavioural therapy - educating the patient;

2. Removing factors that cause the bladder to be overactive, for example medication on a doctor's advice, caffeinated beverages, spicy foods etc;

3. A diary of fluid/dietary intake output;

4. Bladder training;

5. Pelvic-floor physiotherapy.

Dr Buchanan also notes that there are medications that can help, as well, such as anticholinergics, stolterodine and tricyclic antidepressants. She adds that you can also do surgical therapy, but that it should be a last resort and is usually rarely needed.

Most importantly, if you feel you are going more than you should, visit your doctor.