UNSTABLE BLADDER

What is it?

Normally when you decide that you want to pass water, you send a message from your brain to your bladder telling the muscles of the bladder wall to squeeze, letting the water out. If you have an unstable bladder, you will find that sometimes the bladder muscles contract without you telling them to, causing you to wet yourself.

What causes it?

There is often no cause found for an unstable bladder. It is sometimes brought on by taking water tablets and may be caused by having a hysterectomy or, very occasionally, by diseases of the nervous system.

Who gets it?

Virtually all sufferers are women, mostly over the age of 25. It is remarkably common, but sadly, because it is an embarrassing problem, it is not often discussed.

What are the symptoms?

You will usually notice that you have a strong urge to pass water, often when it is too late to find a toilet. You will probably also find that you feel the need to pass water very often and have to get up at night to do so. You may find that you wet the bed.

When should I go to my GP?

You should make an appointment to discuss the problem with your GP as soon as your symptoms become a nuisance. If you also notice burning and stinging when you pass water, you should go along more quickly, since this may suggest that you have a urine infection which can be quickly and easily treated. You should certainly not put off going to see your GP out of embarrassment. GPs see many people with this problem.

What tests will my Doctor want to do?

Your GP will probably want to examine you and may also do an internal examination. He or she may send off a urine sample and send you for special X-rays which look at what happens to your bladder when it fills up and empties.

What is the short-term treatment?

In the short term, your GP may give you a urine diary in which you record every time you pass water and every time you wet yourself. This will give your GP a good idea of how bad the problem is and how best to tackle it. One of the best and most common treatments is bladder retraining. Your GP or practice nurse will give you a series of goals of only passing water every so often. Each time you reach your target without any accidents for a few days, you move on to your next goal which is to wait longer between trips to the toilet. This does take time and effort on your part, but it has a high success rate. Sometimes your GP will give you tablets instead of, or as well as, bladder training.

What is the long-term treatment?

This depends on how successful the bladder exercises are. Sometimes you will need to stay on tablets for some time, but your GP will probably wean you off them.

How can I stop it from getting worse?

The most important thing to do is to keep going with the bladder exercises and not to cheat with them. Cheating doesn't help anyone, especially you. You should make sure you do not get constipated and should try to lose weight if you are overweight.

Will I need regular check-ups?

Yes, while you are going through the bladder exercises, so the doctor or nurse can keep an eye on how you are doing. Once the problem is better, you will only need to come back if you get the problem again.

Will I need to go to hospital?

This depends on how the bladder exercises and tablets help. A few people need an operation if the symptoms are very severe.