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Overactive bladder

Overactive bladder

Have you had to rush to the toilet, or has the urge been so strong that you sometimes did not make it in time? If you wake at night needing to urinate…

To understand this syndrome better we need to know how the bladder works. The bladder is a balloon-shaped organ in the lower abdomen that stores urine coming from the kidneys through the ureters; it is then expelled through the urethra.

The bladder also has involuntary muscle fibres known as the detrusor, in its walls. When they contract they push urine from the bladder into the urethra to be expelled, and that is how voiding begins.

This can occur in men and women, at any age. It has a negative impact on those who have it, affecting daily life: even leaving home can be emotionally draining just thinking whether a toilet will be nearby whenever that overwhelming urge appears. Measures people take often include drinking less, using pads, sanitary towels or even nappies.

Many also isolate themselves and avoid social contact for fear of an accident. Sleep is often disrupted because people get up repeatedly, which can lead to irritability and feeling misunderstood.

Treatment starts with lifestyle changes such as stopping alcoholic and carbonated drinks, as well as caffeine and theine, because these act as diuretics, increase urine production and stimulate the bladder.

Bladder training also matters: the aim is to restore a normal emptying pattern, ideally voiding every 2 to 3 hours. A voiding diary, kept for several days, records the number of voids each day and fluid intake. This helps create a scheduled voiding plan, gradually delaying emptying until the expected interval between voids is reached.

We also work on pelvic floor muscle strength and balance with lumbo-abdominal muscle activation.

Equipment techniques include:

Peripheral neuromodulation, an electrotherapy technique that aims to inhibit the bladder reflex, reducing voiding frequency, urgency episodes and the severity of leaks.

Radiofrequency: energy transfer that stimulates microcirculation in the organ treated and thus collagen and elastin production, helping restore adequate bladder and voiding function. Tesla Care: an electromagnetic-field device used to speed pelvic floor strengthening through contractions applied to the pelvic muscles. Another applicator at the lower back helps at peripheral nerve level, acting on inhibition of the bladder-emptying reflex.