Overactive bladder

Overactive bladder symptoms include the sudden urge to pass urine, going too often, urinary leakage after a sudden urge and getting up frequently at night to go to the toilet.

This is a very common condition which can have a significant impact on day-to-day activities, work and quality of life. There are a variety of effective treatment options for this including bladder retraining, drug treatment and bladder Botox injections. More invasive surgical treatment is now rarely required.

Bladder Botox injections

The detrusor is a layer of muscle wrapped around the bladder which contracts to empty the bladder when you pass urine. Overactive bladder symptoms are often caused by overactivity of this muscle (“detrusor overactivity” – DO). DO is sometimes caused by neurological problems but more often no cause is identified. Bladder Botox injections treat DO by partially paralysing the detrusor muscle and by interfering with the sensitivity of the bladder.

This treatment can also be helpful in Bladder Pain Syndrome. Bladder Botox injections can be given under general or local anaesthetic. A cystoscope (a fine telescope) is introduced down the water pipe into the bladder and dilute Botox is carefully injected into 20 areas spread throughout the bladder. The treatment drastically decreases urinary urgency, frequency and leakage but gradually wears off so repeat treatments are required every 12 months or so. Many people find repeat treatments under local anaesthetic more convenient.

Interstitial Cystitis (IC) / Bladdar Pain Syndrome

IC often called Bladdar Pain Syndrome is characterised by symptoms including urinary urgency and frequency and, especially, lower abdominal discomfort when the bladder is full, with some relief of pain on passing urine. The cause of IC is not fully understood but contributory factors may include dietary triggers, problems with the normal lining of the bladder, changes in nerves within the bladder and abnormal function of the immune system.

Treatment options

In some people the symptoms are quite minor, in others they are much more severe and debilitating, and in others they can fluctuate between extremes. There are many effective treatments available, ranging from lifestyle and dietary advice, to medications (some taken by mouth and some put into the bladder), to bladder Botox injections. Occasionally, more invasive treatments and operations are required.

It is important for these symptoms to be assessed and addressed early on. People often respond differently to the various treatments so it is important for management to be individualised.