How does the urinary system work?
Urine is constantly produced by the kidneys. It then passes down the ureters (tubes from the kidneys) to the bladder.
The bladder acts as a storage organ, which expands as it fills like a balloon. As the bladder fills messages are sent to the brain. When there is about three quarters of a pint of urine (250-400 ml), a strong desire to pass urine is felt. Most people will pass urine approximately 4-8 times during the day and perhaps once during the night.
What is an overactive bladder?
An overactive bladder can contract suddenly before you are ready to go to the toilet. This can give you an urgent feeling to pass urine, and sometimes a leakage of urine. Problems can occur during the day and also at night and can occur at any age. This is common and not simply a part of ageing. Approximately one in four or 5 women have this problem.
Symptoms include:
- Urgency –— a strong urgent desire to empty the bladder.
- Frequency-–needing to pass urine more than 8 times daily.
- Urge incontinence—leakage of urine before getting to the toilet.
- Nocturia — passing urine during the night.
- Nocturnal enuresis — leakage of urine whilst sleeping.
Advice on fluids
Caffeine can make symptoms worse and is found in tea, coffee and ‘fizzy’ drinks. Try changing to decaffeinated brands, but even just reducing these types of drinks can make a significant improvement.
Do not make the mistake of cutting back on fluids altogether, as this can make the urine concentrated (strong smelling and dark yellow) and this is more likely to irritate the bladder. Aim to drink approximately one and a half to two litres of fluid per day, preferably water and diluted juice. Some women find that cranberry juice helps their symptoms.
Lifestyle changes
- Being overweight can put pressure on your bladder, so maintaining a healthy weight can help.
- Smoking cessation is recommended as nicotine can irritate the bladder muscle, also coughing leads to an increase in pressure.
- A diet rich in fibre and regular exercise will help to reduce constipation, regular bowel actions may help bladder control.
- Regular pelvic floor exercises can help strengthen the muscles which can help improve bladder control.
Overactive bladder problems can be helped by a programme of ‘Bladder retraining’. It involves willpower and determination, and it does work. Up to 80%-90% of women find that their problems improve with treatment.
Steps to take
- Begin your bladder retraining programme with a realistic time interval between visits to the toilet that you can manage successfully. This ‘target’ is very individual and the Urogynae nurse can help you with this. Try to distract yourself in some way e.g., Crosswords, word searches, counting back from 100.
- Keep a record of when you go to the toilet and see if you can succeed with your target during the next week. You may need to sit a bit longer, to ensure that you are fully emptying the bladder, rock backwards & forwards
- When you manage your target for one week, increase the time interval again, by 10 – 15 minutes and continue this for another week.
- If you can try to increase the time interval gradually so that after a number of weeks or months you are able to pass urine at longer intervals. Some adjustments might need to be made particularly if you are working.
Gradually you will hopefully be able to stretch the time between going to the toilet. It is usually better to increase your target times slowly. Trying to progress too quickly will probably not bring you success and only discourage you.
This programme can work and put you back in charge of your bladder, and stop letting your bladder control your life.
Persistence and practice will hopefully pay off over time.
Medication
Drugs can be used to give some extra control, although it might take a few weeks for you to notice any improvement. Side effects commonly include a dry mouth or constipation. If these side effects are a problem a different tablet could be given to you. Uncommon side effects include blurred vision, difficulty emptying the bladder or palpitations. If any of these side effects occur, stop taking the tablets and inform your doctor.
Further help
We hope that have found this advice useful. The Urogynae nurse is available to help you with any support that you may need.
Contact information
Urogynae Nurse Practitioner
Monday and Tuesday
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Thursday (3 weeks per month)
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Wednesday (once per month)
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Bladder and Bowel Foundation
A national organisation providing support and information for people with bladder and bowel incontinence