Overactive bladder: desperate to go

Written by: Mr Sachin Malde
Published: | Updated: 08/04/2020
Edited by: Alex Furber

A sudden urge to urinate and the leakage of urine are the classic symptoms of overactive bladder (OAB). The condition can be very distressing for sufferers, who may experience considerable disruption to their work, social life, and sleep, leading to anxiety and depression. Overactive bladder, however, is more common than you might think and there are treatments available, as one of our top London-based consultant urological surgeons Sachin Malde explains.

What are the symptoms of overactive bladder?


Overactive bladder (OAB) is a common condition that can affect people of any age. Typically, the sufferer will experience a sudden, uncontrollable urge to urinate. If this results in the leakage of urine, it is known as urge incontinence. A greater frequency of trips to the loo during the day or at night may also be present with OAB.


What causes overactive bladder?


In most cases, the exact cause of overactive bladder and urge incontinence is unknown, although a number of things can lead to the symptoms of OAB, which can include;

  • Certain medications
  • Diabetes
  • Urinary tract infections
  • Bladder tumours
  • An enlarged prostate gland in men
  • Excessive alcohol
  • Excessive caffeine
  • Incomplete bladder emptying
  • Previous surgical procedures or radiotherapy treatment
  • Conditions that affect the nerve supply to the bladder, such as multiple sclerosis or Parkinson’s disease

Can overactive bladder be treated?


The good news for many is that, depending on the severity of symptoms, overactive bladder can be managed in a range of ways.


Firstly, it is recommended that you reduce your intake of alcohol and caffeine. Thereafter, bladder training has been demonstrated to be effective in improving overactive bladder symptoms. Usually, a specialist is required to produce the best results.


If symptoms remain problematic, tablets may be recommended to relax the bladder. Again, these have been shown to be effective for many patients, although they do carry some potential side effects including dry mouth and constipation.


If these options fail to alleviate symptoms, there are still courses of treatment available; specifically, Botox injections or the use of a ‘bladder pacemaker’ in a procedure known as sacral nerve stimulation.


Bladder Botox injections work by lessening the overactive contractions. The procedure can be performed in 5 to 10 minutes under local anaesthetic and the effects last for 6 to 12 months.


Sacral nerve stimulation, or sacral neuromodulation, uses a pacemaker-like device to send electrical signals to the nerves that control your bladder. The treatment is effective for about 70% of patients.


If you are distressed by symptoms of OAB, then don’t suffer in silence – consult a specialist for advice about treatment.

By Mr Sachin Malde

Mr Sachin Malde is a well-regarded and highly trained Consultant Urological Surgeon based at the renowned Guy's and St Thomas' Hospital in London. Mr Malde qualified from the biggest healthcare training facility in Europe, the historic Guy’s, King’s and St Thomas’ School of Medicine in London, before completing his urology training. He is an expert in the management of urological problems and has specialist interests in bladder cancer, incontinence, urinary infections, bladder problems and prostate diseases. He completed his fellowship training at University College Hospital in London, where he was given an award for his research into incontinence. Mr Malde is keen to offer the most up-to-date treatments and is one of only a handful of urologists performing sacral nerve stimulation for bladder conditions. Enthusiastic about education and the academic side of medicine, he has tutored and lectured nationally and internationally, and has published widely in peer-reviewed journals. Mr Malde is a fellow of the Royal College of Surgeons of England and is a member of the British Association of Urological Surgeons. He is also a member of the European Association of Urology where he sits on the Guidelines panel for male urinary symptoms.

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