Do you feel like you run to the toilet too often during the day?
Do you have to get up a lot at night time to pee?
When you feel the urge to pee do you have to get to the toilet straight away?
If you don’t make it to the toilet in time do you ever accidentally leak urine?
Do you know where all the public toilets are when you go into town?
If the answer is ‘yes’, you might have overactive bladder syndrome (OAB). OAB affects 12% of people and can impact significantly on quality of life. I often meet women who have adjusted their lifestyle to cope with their overactive bladder problem, such as avoiding social occasions with friends and family for fear of leaking urine. The good news is that these problems can often be completely cured.
Before women come to see me with overactive bladder problems I recommend trying simple lifestyle modifications such as cutting down on tea & coffee and reducing fluid intake in the evening. These simple adjustments can sometimes make a big difference. Next step is usually bladder re-training and pelvic floor exercises
(Please see the information section for more detailed advice).
Tablets for overactive bladder can be effective for some women. Side-effects include dry mouth and constipation, and some tablets can cause problems with high blood pressure.
Botox® bladder injections can be a very effective treatment, often leading to significant improvement in quality of life, although carry a 15% risk of causing problems with bladder emptying. Treatment effects wear off usually after about 6-9 months. Some private health insurance companies will cover your first Botox® treatment.
Do you experience pain, pressure or discomfort in your bladder?
Is this pain relieved passing urine?
Is the pain in your bladder worse with sex, eating spicy or acidic foods, drinking coffee?
If the answer is ‘yes’, you may be suffering from Bladder Pain Syndrome (BPS). This condition is often associated with reduced quality of life, low self-esteem and can cause problems with your sex life. It affects around 5% of the population and is 5 times more common in women than men.
I often see women with BPS that has gone undiagnosed for many years. The first step is to rule out other causes of pain such as urinary tract infection, bladder stones, endometriosis or bowel problems. Sometimes investigations are needed such as urodynamics or a camera test of your bladder (cystoscopy).
I offer the following treatments for bladder pain:
Medication (cimetidine, amitriptyline)
Bladder instillation therapy
Botox® bladder injections