Urgency – a feeling that you have to rush to the toilet to avoid wetting yourself – is also known as overactive bladder, especially if it also occurs with frequency (going too frequently) or nocturia (having to wake up overnight to empty your bladder).
Overactive bladder is not a diagnosis – just a description of symptoms. Urgency and overactive bladder can have numerous causes, including a urinary tract infection or something more serious like bladder cancer, so it is always best to see your GP first if you have these symptoms.
Overactive bladder can be linked with a condition called detrusor overactivity. Detrusor overactivity is diagnosed by having a special bladder test called urodynamic studies. In urodynamics, your bladder is filled up with fluid via a catheter in the urethra (the tube you pass urine through). Your bladder muscle, the detrusor, should remain relaxed while this is done (believe it or not!) If your detrusor starts to contract, which is what it normally does when you pass urine, you are given the diagnosis of detrusor overactivity. (The old name for this was detrusor instability). Anticholinergic medications are often prescribed for detrusor overactivity.
Urgency and overactive bladder can occur with or without detrusor overactivity. Regardless of whether you are given medication, these symptoms often require treatment by a pelvic floor physiotherapist.
To treat urgency and overactive bladder, we may assess and treat your pelvic floor muscles, and give you a home program. We will often require you to fill out something called a ”bladder diary”, to give us more information about some of the causes of the urgency. We also teach you strategies to control the urge. We may need to do something called ”bladder training” in order to reduce or eliminate the urgency. For some people, certain dietary supplements are very helpful for urgency symptoms, and we have these available at Equilibria. TENS machines (which some people use for back pain) can sometimes be very helpful for urgency when used as prescribed by a pelvic floor physiotherapist. At Equilibria, TENS machines are available for hire or purchase for you to use at home.