Overactive Bladder FAQs

What is Overactive Bladder?

Overactive bladder (OAB) is a condition characterised by involuntary contractions of the bladder muscles (detrusor muscle). The bladder is controlled by a complex network of nerves and muscles that work together to store and release urine. When the bladder is full, receptors which detect stretch of the bladder wall send nerve signals to the brain, which interprets the signals as the need to urinate. In individuals with OAB, this detection/signaling process can become disrupted, leading to a sensation of urgency even when the bladder isn’t full and an increased frequency of urination.

What are the symptoms of overactive bladder in men?

Symptoms of OAB in men may include sudden, intense urges to urinate that cannot be delayed, high frequency of urination (eight or more times per day), waking up at night to urinate (nocturia), and urge urinary incontinence (having such a strong urge to pee that some urine is leaked).

How does overactive bladder impact people?

OAB can have significant impacts on the lives of those experiencing the symptoms from it. It can be extremely limiting in social situations, making people avoid engaging in interactions due to fear of leaking or embarrassment. It can be restrictive for people to be able to engage in healthy habits such as exercise. Often people suffering from OAB will have their daily lives, routines and movements dictated by their symptoms such as planning out where they go based on availability of toilets, limiting variety of areas they go where they go due to familiarity of where bathrooms are located, peeing (or trying to) before every activity or going out.

What are the causes of overactive bladder?

While there is no specific cause of OAB in most cases, symptoms can occur secondary to an enlarged prostate as a result of benign prostate hyperplasia or prostate cancer, which can put pressure on the bladder, reducing its capacity and irritating the bladder wall.
Neurological conditions, such as damage or dysfunction to the nerves that control the bladder, can cause OAB. This may be due to conditions such as multiple sclerosis, Parkinson's disease, or a spinal cord injury.
Other conditions may cause symptoms like that of OAB, however are specific and treated accordingly such as urinary tract infections (UTI), bladder stones, bladder cancer, polyuria (increased urine production by the kidneys)
Psychological factors: Anxiety, stress, and depression can exacerbate OAB symptoms.

How common is overactive bladder in men?

Overactive bladder affects about 11.8% of men aged 40 years or more. This prevalence increases with age , affecting 7.9% in men aged 40-49 years, 13.7% in men aged 50-59 years, 16.6% in men aged 60-69 years, and 20.3% in men aged 70 years and older.

How is overactive bladder diagnosed?

Overactive bladder is a clinical diagnosis, meaning it is diagnosed based on the symptoms of the condition outlined above. Other tests may be performed to rule out other potential causes of the same symptoms such as urinalysis to rule out urinary tract infection. Once these are ruled out, a diagnosis of OAB can be made.

Other tests which may be performed are urodynamic tests (obtaining measures of flow & pressures), Post-void residual volume (PVR) to measure urine left in the bladder after urinating and bladder dairy (measuring frequency and volume of voids across a (usually) 3 day period).

How can physiotherapy help with overactive bladder?

Physiotherapy can help with the management of overactive bladder using a few different methods, used in conjunction with each other. These involve pelvic floor muscle training, bladder retraining & optimising lifestyle factors which negatively impact OAB.

A men’s health physiotherapist will help walk with you along your rehabilitation journey with your OAB symptoms to help with progression as you conquer these symptoms, to aid when you have setbacks (which are likely) and provide guidance on managing day to day with OAB symptoms.

What is pelvic floor muscle training?

Pelvic floor muscle training involves voluntary contraction of the pelvic floor muscles. These muscles increase pressure in the urethra, helping control leakage of urine whenever strong urges arise.

A men’s health physiotherapist can help guide you through the correct technique and dosage of pelvic floor muscle training and use feedback such as real time ultrasound to ensure you are able to do the exercises correctly. These can be quite challenging.

What is bladder re-training?

Bladder training is a process by which we retrain the communication between the bladder and the brain to restore normal signalling that the bladder is full. This involves gradually increasing time between visits to the bathroom either by sticking to a set schedule & slowly extending the duration between bathroom visits or by deferring bathroom visits when you get urges. This helps ‘stretch’, or rather, improve the bladder's tolerability to stretch and how soon it signals to the brain that it is full.

Distraction and relaxation techniques can be used to help reduce the intensity of urges during the training process.

What lifestyle changes can help me with management of overactive bladder?

Certain lifestyle factors can lead to increased irritation of the bladder, exacerbating OAB symptoms

Certain foods and drinks can have an irritating effect on the bladder, contributing to an increase in muscle activity of the bladder and OAB symptoms. These include particularly caffeine, alcohol, spicy foods

Weight management: Maintaining a healthy weight can help reduce pressure on the bladder and improve bladder control.

How long does it take to improve overactive bladder?

It will likely take several months to overcome the effects of overactive bladder. It can take some time to improve strength & control of pelvic floor muscles and improve the communication of nerve signalling between the bladder and the brain.