An overactive bladder (OAB) or urinary urgency is when you have an overwhelming urge to wee which can be difficult to hold. When you have OAB you may also feel the urge to wee more frequently during the day and/or night. Your bladder could be contracting, tell you to wee, at smaller than normal volumes or contracting due to a specific trigger (i.e., key in door, caffeine). This may or may not involve the involuntary loss of urine/incontinence.

To determine if you have OAB its helpful to know what is normal for the bladder. It is normal to wee every 2-3hrs or 4-7 voids per day and perhaps once overnight. Normal daytime urinary volumes are 250-400mls and the first void of the day can be up to 600mls. Most importantly, you should be able to defer passing a wee until it suits you. You should be able to walk calmly to the toilet, undress and sit down easily before urination begins.

So, what do you do if your bladder doesn’t seem to be normal?

Firstly, it is helpful to adopt some good bladder habits. Make sure you are drinking enough, 1.5-2.0L of fluid daily, and avoid drinking fluids for approximately 1.5 hours before bedtime. If you have urgency, practice holding on until the urge subsides and make sure you are completing your pelvic floor exercises as guided by your pelvic floor/continence trained physiotherapist.

There are also a few things to avoid when you have OAB. Try to avoid running to the toilet as soon as you have an urge or going to the toilet “just in case”. It is also helpful to ensure you are not constipated or straining when passing urine or faeces. Avoiding known bladder irritants may help, including caffeine, alcohol, fizzy drinks, and artificial sugars.

If you are still having trouble managing your OAB, particularly if this is resulting in urinary incontinence, consider getting some extra help from our continence-trained physiotherapist Meghann Cutler for more specific advice for your situation.