Management of Overactive Bladder Disorder

Overactive bladder disorder (OAB) is a debilitating condition which can result in embarrassment and social isolation. It can restrict activities and impact many aspects of life.

Many sufferers do not seek treatment because they think overactive bladder dysfunction and urinary incontinence is a normal consequence of ageing.

However, treatments are available for men and women and can result in a significant improvement in the quality of life.

What is OAB?

Overactive bladder disorder occurs when the bladder muscle contracts without permission. This may create a sense of urgency or even urge incontinence.

Symptoms of OAB include:

Frequency: passing urine more than 8 times per day 1
Urgency: the sudden urge to pass urine which is difficult to ignore.
Nocturia: waking up more than once at night to pass urine.
Incontinence: leakage of urine that you can’t stop.
Urge incontinence: leakage accompanied by or immediately preceded by a sudden feeling of urgency.
Overactive bladder disorder
Overactive bladder disorder involves contraction of the bladder muscle at the wrong time resulting in urgency, frequency and urge incontinence.

Diagnosis of OAB

The above symptoms can coexist with other bladder conditions: in women, especially stress incontinence. It is important to manage both conditions. For the management of stress incontinence weight loss, pelvic floor training and minimally invasive suburethral sling surgery is available.

For some patients, urodynamic testing is necessary to achieve the best outcome for bladder control. This is a sophisticated diagnostic procedure that enables a precise diagnosis of the causes of bladder symptoms.

This study takes half an hour and involves the passage of a small computer probe through the urethra into the bladder to measure bladder pressures and to detect bladder contractions.

Urodynamic testing and non-anaesthetic flexible cystoscopy are performed by Dr Katelaris in the urology outpatient clinic at Palmerston Road, Hornsby.

In clinical trials using botox therapy:

  • The majority of patients had at least a 50% reduction of daily leakage episodes
  • Around half reduced their leakage episodes by 75%
  • 1 in 4 patients reported no leakage at 12 weeks
  • All studies reported significant responses to Botox when compared

Treatment for OAB

Conservative therapies such as bladder retraining is effective for many women. This involves drinking 2 L of water per day and progressively deferring bladder emptying for longer and longer periods of time. The normal adult bladder should hold comfortably 500 mL for a period of 4 to 5 hours. Minimising caffeinated drinks also helps.

Pelvic floor training is an important part of treatment. It aids with stress leakage of urine and for women with urinary urgency, helps to suppress the bladder contraction that results in urgency and even urges incontinence.

There are a number of modern medications that are proving very effective for the management of OAB. These should be trialled as first-line therapy for urinary frequency, urgency, and urge incontinence in concert with bladder training programs.

Bladder Botox Therapy

Bladder Botox Therapy
Botox is injected into multiple sites throughout the bladder and prevents the bladder muscle from aberrantly contracting.

For people whose bladder condition does not respond to bladder training, pelvic floor exercises, or oral medication, Botox bladder injection therapy should be considered.

Botox therapy works by reducing the ability of the bladder muscle to contract by interfering with the chemical signalling between nerves and muscles. The Botox medication is injected directly into the bladder muscle under local anaesthetic by the passage of a small telescope into the bladder.

The Bladder Botox Clinic Offers

  • Assessment by urodynamics to ensure accurate diagnosis
  • Pelvic floor training under supervision of an experienced urology nurse
  • Convenient walk in walk out bladder botox injections under local anaesthesia

One injection of Botox into the bladder muscle may be effective for between 6 to 12 months.

A comprehensive bladder program is offered at the Bladder Botox clinic following assessment by an expert urologist, Dr Phillip Katelaris.

The clinic offers sophisticated urodynamic testing and non-anaesthetic flexible cystourethroscopy when indicated, bladder training and training in pelvic floor exercises with a specialist urological nurse, Mrs Libby King.

Should Botox therapy be required, a walk-in walkout model has been developed for patients to undergo the procedure under local anaesthetic. Patients are able to drive home after the procedure.