Overactive bladder is the term used to describe a constellation of symptoms. The hallmark symptom is urinary urgency, meaning that when you feel the need to go, there’s no delaying it. Other symptoms, which some but not all women with overactive bladder experience, include needing to go many times a day, being woken up in the middle of the night by the need to go, and leaking urine before reaching the washroom.
Women often find these symptoms embarrassing and difficult to talk about. Assuming that there’s nothing to be done, they may never speak to their doctor. And that’s a mistake, because there’s so much that can be done to help. “A lot of benefit comes from simply understanding the symptoms,” says Dr. Blayne Welk, Urologist at St. Joseph’s Hospital in London, ON. “There’s a large psychological benefit to having a discussion with your physician to understand that it’s a common condition, it’s not dangerous, and it can be managed with various techniques.”
Lifestyle changes are the first step to management
Once a woman receives a diagnosis of overactive bladder, the first line of treatment is always conservative and non-medical. “Lifestyle modifications are essential, as is behaviour management,” says Dr. Duane Hickling, Urologist at The Ottawa Hospital. “One of the first lifestyle modifications that I typically suggest is to limit total daily fluid intake to approximately 1.5 litres and to space this out throughout the day. The type of fluid consumed is also important. Water is always preferable and any caffeinated, alcoholic, or carbonated beverages can have a negative effect on overactive bladder symptoms.”
Other lifestyle changes include pelvic floor physiotherapy and bladder training, through the scheduling of bathroom breaks. When lifestyle changes are not enough, the second line of treatment is medication. In fact, it’s becoming more common to begin medication simultaneously, as the two can work together synergistically, with lifestyle changes improving the response to medication.
Options for safe and effective medication
There are a wide variety of oral medications — spread across two different categories — available that can help alleviate the symptoms of overactive bladder. These work to manage symptoms in different ways. For example, one of the newer medications provides relief by relaxing the bladder muscle, allowing additional urine to be stored without urgency. All the medications approved in Canada are easy to take, safe, and effective. There are, however, some differences in side effect profiles as well as individual responses, so the best drug for one person may not be the best for another.
Regardless of the medication your health care provider recommends, it’s important to know that they can take a month or more to begin to really work, so sticking with your treatment plan is essential. “One of the keys to treating overactive bladder is to discuss expectations up front,” says Dr. Welk. “The most important thing I tell women regarding the medications is to not expect changes overnight.”
It may take time, but alleviation of symptoms is possible. With a commitment to treatment, almost everyone can find their way to an improved quality of life, free from the constraints of overactive bladder. “We have this well-established toolbox, and we’re usually quite successful at managing overactive bladder symptoms with the tools we have,” says Dr. Hickling. “There are many ways to make this more manageable and to improve quality of life.”
If you are experiencing overactive bladder symptoms you should consider speaking with your physician. If you’re looking for additional resources, the Canadian Urological Association is dedicated to providing the public with trusted information about overactive bladder symptoms and treatment. Please visit www.cua.org/en/patient to learn more.
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