Personalized Care for Your Health

Overactive Bladder Treatment

Overactive Bladder (OAB) is a medical condition characterised by the sudden urge to urinate, which may be difficult to control. This urge may lead to the frequent need to urinate throughout the day and night.

OAB can significantly impact an individual’s quality of life, affecting daily activities, sleep, and emotional well-being.

BOOK AN APPOINTMENT

Causes of Overactive Bladder

Nerve signals and bladder communication: Proper bladder function relies on coordinated communication between the bladder and the brain.

Disrupted signals: Damage or abnormalities in the nerves or in the brain regions responsible for bladder control can lead to miscommunication, causing premature bladder contractions.
Underlying conditions: Diseases such as diabetes or spinal cord injuries can affect nerve health, leading to OAB symptoms.

Overactive bladder muscles: The bladder’s detrusor muscle plays a pivotal role in urine storage and release.

Involuntary contractions: If the detrusor muscle becomes overactive, it can contract spontaneously, even when the bladder isn’t full, resulting in a sudden urge to urinate.

Risk Factors

Several factors can increase the risk of developing OAB:

Neurological disorders: Certain neurological conditions can disrupt the nerve signals related to bladder control. For instance:

Stroke: Damage to brain areas controlling bladder function can lead to OAB.
Multiple sclerosis: This autoimmune disease affects the central nervous system, potentially impacting bladder control.
Parkinson’s disease: A progressive nervous system disorder, it can interfere with the coordination of bladder and urethral muscles.

Hormone changes: The decline in oestrogen levels after menopause can affect the urinary tract’s health. This hormonal change can thin the tissues of the bladder and urethra, increasing the risk of OAB in post-menopausal women.

Pelvic muscle issues: The muscles in the pelvic region play a crucial role in supporting the bladder and controlling urine release. Factors such as childbirth, surgery, or trauma can weaken or damage these muscles, leading to OAB symptoms.

Diagnosis of Overactive Bladder

Medical history and physical examination:

Symptom assessment: A urologist will review the patient’s symptoms, frequency of urination, and any episodes of urgency or incontinence.
Physical examination: This may include a pelvic exam for women and a prostate examination for men to check for physical conditions affecting bladder function.

Bladder diary:

Recording habits: Patients may be asked to maintain a diary for several days, noting the times of fluid intake, urination, and any leakage episodes.
Analysis: The diary provides insights into daily patterns and can help identify triggers or specific times when symptoms are worse.

Urine tests:

Urine analysis: A sample of urine is checked for signs of infection, blood, or other abnormalities that might be causing or exacerbating OAB symptoms.
Culture: If an infection is suspected, a culture can identify the specific bacteria present.

Bladder scans:

Post-void residual measurement: After the patient urinates, an ultrasound device measures the amount of urine remaining in the bladder. A significant amount of residual urine can indicate issues with bladder emptying.
Bladder wall thickness: In some cases, the thickness of the bladder wall may be measured, as increased thickness can be associated with OAB.

Get an Accurate Diagnosis & Proper Treatment
for Your Urological Conditions

make an enquiry

Treatment Options for Overactive Bladder

Lifestyle changes

Dietary adjustments: Consuming certain foods and drinks can irritate the bladder. Reducing or eliminating caffeine, alcohol, spicy foods, and acidic fruits can help manage symptoms.
Bladder training: This involves setting scheduled times to urinate and gradually increasing the intervals between urination, helping the bladder to hold more urine over time.
Pelvic floor exercises: Also known as Kegel exercises, these strengthen the muscles that help control urination, improving bladder control.

Prescription drugs

Antimuscarinics: These drugs, such as oxybutynin and tolterodine, work by blocking specific receptors in the bladder, reducing involuntary contractions.
Beta-3 agonists: Mirabegron is an example that relaxes the bladder muscle, allowing it to store more urine.
Combination drugs: Some patients may benefit from a combination of medications to address multiple symptoms or mechanisms of OAB.

Bladder Botox treatment

Procedure: OnabotulinumtoxinA (Botox) is injected into the bladder muscle, causing it to relax and increasing its storage capacity.
Duration: The effects can last several months, after which repeat treatments may be needed.

Nerve Stimulation

PTNS (Percutaneous Tibial Nerve Stimulation): A needle electrode is inserted near the ankle. Electrical impulses are sent to the tibial nerve, which then sends signals to the spine and helps modulate bladder control.
SNS (Sacral Nerve Stimulation): A device is implanted under the skin, sending electrical impulses to the sacral nerves, which play a role in bladder control.

Surgical Options

For those who don’t respond to other treatments, surgical interventions may be considered.

Bladder reconstruction: This surgery increases the bladder’s storage capacity while reducing pressure within it.
Urinary diversion: In severe cases, urine can be diverted to an external bag or a constructed internal reservoir, bypassing the bladder entirely.

Conclusion

Overactive Bladder is a condition that can significantly impact daily life, but a range of treatments is available. From lifestyle changes to surgical interventions, individuals with OAB have multiple avenues to explore for symptom relief. For those experiencing symptoms, consult a urologist to determine the best course of action.

Dr Lee Fang Jann

Urologist & Renal Transplant Surgeon

Dr Lee is a urologist and kidney transplant surgeon with a broad-based expertise of all urological disorders

He has subspecialty focus on men’s health and male infertility, and special interest in minimally invasive prostate enlargement therapy and kidney stone treatment. Dr Lee has received numerous awards for service excellence such as the Service With A Heart Award (2006-2008, 2011) and the Singapore Health Quality Service Award (2016).

Bachelor of Medicine and Bachelor of Surgery (Singapore)
Membership of The Royal College of Surgeons (Edin)
Master of Medicine (Surgery) (Singapore)
Fellowship of the Academy of Medicine (Urology)
Clinical fellowship at Oxford Transplant Centre in the UK

Prior to entering private practice, Dr Lee served in the public sector for 16 years at SGH, where he initiated dedicated clinics evaluating and treating patients with complex men’s health and fertility issues. He also led the Renal Transplant Program and laparoscopic donor nephrectomy service as Surgical Director.

Apart from clinical work, Dr Lee is active in academia and believes in the importance of grooming the next generation of doctor. He was Senior Clinical Lecturer at NUS’ Yong Loo Lin School of Medicine and currently, Adjunct Assistant Professor at the Duke-NUS Medical School. Dr Lee is also regularly invited to share his experiences locally and regionally through lectures, workshops and surgical demonstrations.