Frequent voiding (The Overactive Bladder Syndrome) is a common problem. Affecting women more than men it affects patients quality of life and can occur due to underlying bladder problems. Treatment in the past has been predominatley with tablets and major surgery but now more minimally invasive treatment options are available after consultation with your specialist.
Assessment and treatment concentrate on identifying the underlying problems with the bladder. Your specialist will need to talk through your symptoms with you (History) and then examine you. The investigations required are very variable but include flow tests, a bladder scan or urodynamics (pressure testing of the bladder). Your specialist may ask you to record your fluid intake and how much urine you produce each day (input/output chart) or fill in a symptom questionnaire (download overactive bladder questionnaire). You may need a cystoscopy (bladder examination) [/tab]
The treatment of the overactive bladder ranges from simple measures to more complex treatments. This is best thought as levels of treatment.
Level 1 – Lifestyle changes and pelvic floor exercises
By decreasing your caffeinated fluid intake (Coffee, Tea, Cola drinks) many patients will improve their frquent voiding. Simply avoiding diuretics can give relief.
Medications can be very effective in improving overactive bladder symptoms. These are drugs called anti-cholinergics and stop the nervous impulses to your bladder.
Level 3 – Minimally invasive treatments
If other treatments have not been effective, frequent voiding can be successfully treated with new treatments such as PTNS (percutaneous tibial nerve stimulation) or intravesical botox injections. PTNS is a method of reducing the nerve stimulation of the bladder, using weekly needle electrical stmulation of the tibial nerve, which is present at the ankle. Intravesical botox treatment is a single procudure in which multiple small injections of botox are put into the bladder. With the option of having this performed under local anaesthetic this can be performed as an outpatient procedure and can be repeated if required. These treatments will need a thorough discussion with your consultant before one is performed. [/tab]