Urgency is considered the hallmark symptom of OAB, but there are no clear criteria for what constitutes urgency and studies often use other criteria. Urgency is currently defined by the International Continence Society (ICS), as of 2002, as “Sudden, compelling desire to pass urine that is difficult to defer.” The previous definition was “Strong desire to void accompanied by fear of leakage or pain.” The definition does not address the immediacy of the urge to void and has been criticized as subjective.
Botox: Small doses of Botox injections can paralyze bladder muscles. This stops them from contracting too often. Results last about 12 weeks, so you’ll need repeated treatments. Possible side effects include an inability to empty the bladder completely.
Franco, E., Pares, D., Colomé, N. L., Paredes, J. R. M., & Tardiu, L. A. (2014, November). Urinary incontinence during pregnancy. Is there a difference between first and third trimester [Abstract]? European Journal of Obstetrics & Gynecology and Reproductive Biology, 182, 86-90. Retrieved from http://www.ejog.org/article/S0301-2115(14)00468-0/abstract
One of the reasons for stress incontinence may be weak pelvic muscles, the muscles that hold the bladder in place and hold urine inside. A pessary is a stiff ring that a doctor or nurse inserts into the vagina, where it presses against the wall of the vagina and the nearby urethra. The pressure helps reposition the urethra, leading to less stress leakage. If you use a pessary, you should watch for possible vaginal and urinary tract infections and see your doctor regularly.
During childbirth, 3 types of lesions can occur: levator ani muscle tears, connective tissue breaks, and pudendal/pelvic nerve denervation. Any of these injuries can occur in isolation but 2 or more in combination are more likely to occur. The long-term result may be the loss of active and passive urethral support and loss of intrinsic urethral tone.
Absorbent products (include shields, undergarments, protective underwear, briefs, diapers, adult diapers and underpants) are the best known product types to manage incontinence. They are generally easy to get hold of in pharmacies or supermarkets. The advantages of using these are that they barely need any fitting or introduction by a health care specialist. The disadvantages with absorbent products are that they can be bulky, leak, have odors and can cause skin breakdown.
OAB occurs in both men and women. It’s possible to have overactive bladder at any point in your life. But, it’s especially common in older adults. The prevalence of OAB in people younger than 50 years of age is less than 10 percent. After the age of 60, the prevalence increases to 20 to 30 percent. (11)
^ Lipp, A; Shaw, C; Glavind, K (17 December 2014). “Mechanical devices for urinary incontinence in women”. The Cochrane Database of Systematic Reviews. 12: CD001756. doi:10.1002/14651858.CD001756.pub6. PMID 25517397.
Intrinsic sphincter deficiency is a condition in which the urethral sphincter is unable to coapt and generate enough resting urethral closing pressure to retain urine in the bladder. The anatomic support of the urethra may be normal.
It important that the clinician and the patient both reach a consensus on the term, ‘urgency.’ Some common phrases used to describe OAB include, ‘When I’ve got to go, I’ve got to go,’ or ‘When I have to go, I have to rush, because I think I will wet myself.’ Hence the term, ‘fear of leakage,’ is an important concept to patients.
Electrodes are temporarily inserted into your rectum or vagina to stimulate and strengthen pelvic floor muscles. Gentle electrical stimulation can be effective for stress incontinence and urge incontinence, but you may need multiple treatments over several months.
Incontinence refers to either urinary incontinence which is the inability to control bladder function or faecal incontinence, the inability to control bowel function. Learn more about the symptoms, treatment options and causes of incontinence here.
Overactive bladder (OAB) is a condition that is characterized by sudden, involuntary contraction of the muscle in the wall of the urinary bladder. This results in a sudden, compelling need to urinate that is difficult to suppress (urinary urgency), even though the bladder may only contain a small amount of urine. The key symptom is sudden urge to void (urgency) with or without urgency urinary incontinence, often associated with urinary frequency (voiding 8 or more times per day) and nocturia (awakening one or more times at night to void). Irritating fluids, such as caffeinated beverages (coffee, tea), spicy foods, and alcohol can worsen the symptoms. It is common for those affected to compensate for OAB by toilet mapping, fluid restriction, and timed voiding. There is no pain, burning, or blood in the urine with OAB.
^ Thom, DH; Rortveit, G (December 2010). “Prevalence of postpartum urinary incontinence: a systematic review”. Acta Obstetricia et Gynecologica Scandinavica. 89 (12): 1511–22. doi:10.3109/00016349.2010.526188. PMID 21050146.
Incontinence is a term that describes any accidental or involuntary loss of urine from the bladder (urinary incontinence) or bowel motion, faeces or wind from the bowel (faecal or bowel incontinence).
A variety of bulking agents, such as collagen and carbon spheres, are available for injection near the urinary sphincter. The doctor injects the bulking agent into tissues around the bladder neck and urethra to make the tissues thicker and close the bladder opening to reduce stress incontinence. After using local anesthesia or sedation, a doctor can inject the material in about half an hour. Over time, the body may slowly eliminate certain bulking agents, so you will need repeat injections. Before you receive an injection, a doctor may perform a skin test to determine whether you could have an allergic reaction to the material. Scientists are testing newer agents, including your own muscle cells, to see if they are effective in treating stress incontinence. Your doctor will discuss which bulking agent may be best for you.
Your GP may advise on treatment or refer you to a continence advisor for advice on bladder training and pelvic floor exercises. Sometimes physiotherapists can help with pelvic floor exercises. In some situations, you and your doctor may decide to wait and see how things go before trying treatment. This is because some mild cases get better on their own over time and without treatment. Sometimes a specialist (usually a urologist or a urogynaecologist if you are a woman) needs to be involved in more difficult cases. Surgery can be used to treat incontinence, especially stress incontinence.