Problems with storage of urine can cause the frequent passing of urine during the day and night, a feeling of urgency or incontinence. This gives rise to the term ‘Overactive bladder’.

Symptoms

Problems passing urine are more common in men, due to obstruction by an enlarged prostate, and these include a slow urinary flow, difficulty in starting to urinate, dribbling and a feeling of poor bladder emptying. Urinary infections may also occur due to poor bladder emptying, weakness of the bladder muscle and inability to empty properly. Post-menopausal women are also more prone to infections due to hormonal changes.

Assessment of ‘complex’ urinary incontinence, including pelvic floor weakness, is ideally managed by a multi-disciplinary team of specialist urologists, gynaecologists and physiotherapists working together to provide a comprehensive service.

Midlands Urology works in partnership with The Bladder Clinic to provide excellence in this area of expertise.

Assessment & Diagnosis

Assessment of bladder function usually involves simple outpatient tests including questionnaires of urinary frequency and fluid intake, physical examination, urine tests, and bladder scanning. Telescopic inspection of the bladder under local anaesthetic may be needed, with ultrasound and X-rays of the kidneys, if bleeding or infections have occurred.

Treatments

Most urinary symptoms improve with altering fluid intake, avoidance of caffeinated drinks, and bladder ‘retraining’. Medical treatment of the overactive bladder with drugs to calm the bladder muscle is often very effective. Surgery to the bladder for urinary symptoms is uncommon, but injection of Botox┬« is a new and effective treatment which is available when oral medications have failed to improve symptoms satisfactorily.

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Peter Cooke

Mr Peter Cooke MB ChB MD FRCS England FRCS Ireland FRCS (Urology) is a leading urological surgeon and cancer specialist.

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