Recent research indicates that the majority of people do not know what overactive bladder (OAB) is, let alone how is can be treated.
In a recent survey carried out in in Munster, Ireland over half the people surveyed did not know what overactive bladder was and 81% avoid visiting their doctor for help with the condition when it first occurs. The research further reveals that over 15% of Irish people experience bladder weakness issues overall – making it a more common condition than diabetes, affecting more than 350,000 people in Ireland.
The new research also revealed that there is confusion over what causes the condition, with 15% of Irish people overall believing it is simply a part of getting older, 34% believing it is a normal part of ageing for women, and 54% incorrectly thinking it is the result of an enlarged prostate for men.
Commenting on the research findings, Dr Suzanne O’Sullivan, President of the Continence Foundation of Ireland and consultant obstetrician and gynaecologist at Cork University Maternity Hospital, said “OAB is a common problem, and whilst the incidence increases with age, it can affect young and old and men and women alike. It tends to creep up on people, and is distressing and embarrassing, having a very negative impact on a sufferer’s quality of life. It leads to low self-esteem and social isolation. Sufferers tend to seek help very late, as most are not aware how common and treatable the condition is.
“OAB occurs when the bladder muscle contracts suddenly and unexpectedly leading to severe urgency and even incontinence.
“Whilst OAB problems become more common with age, it is more common amongst young people than one would imagine. Often it is accepted as a normal part of ageing, but this should not be the case. It is important to understand this is not something that simply has to be tolerated. Once help is sought, and with the proper support, control of the bladder can be regained and the problem sorted.”
Furthermore, 65% of people in Munster do not know there are effective treatments available for OAB. “A worrying number of people are not seeking help for their OAB symptoms due to embarrassment or uncertainty. In today’s world, people prefer to turn to online sources to learn about health issues, especially bladder problems, as they feel awkward discussing this with others,” continued Dr O’Sullivan.
“Anyone with symptoms such as a sudden urge to urinate; urinating 8 or more times in 24 hours; or waking up at night more than once to urinate should speak to their GP to seek treatment. People experiencing this need to know that it’s OK to admit it, and they don’t need to feel embarrassed to talk to their GP,” she concluded.
Aside from the treatment available from GPs, people with OAB can also benefit from physiotherapy to help strengthen their pelvic floor muscles.
According to Maeve Whelan, a chartered physiotherapist in Co Dublin who specialises in pelvic floor treatment: “Most OAB treatment plans include simple lifestyle changes and bladder training techniques, as well as pelvic floor exercises to help strengthen the pelvic floor muscles that support your bladder.”
Fesoterodine fumarate (Toviaz) appears to reduce urge incontinence in patients with overactive bladder who had a suboptimal response to tolterodine tartrate extended release (Detrol LA), according to a phase IV study.
The 14-week randomized, placebo-controlled, double-blind multicenter study assessed fesoterodine, 8 mg, in patients with OAB who had been taking tolterodine, 4 mg, for 2 weeks and had less than 50% reduction in urge urinary incontinence episodes. After open-label treatment with tolterodine, 4 mg, treatment with fesoterodine, 4 mg, was started for 1 week, followed by treatment with fesoterodine, 8 mg.
The study results demonstrated that fesoterodine, 4 mg, for 1 week followed by fesoterodine, 8 mg, statistically significantly reduced the average number of urge urinary incontinence episodes (-2.37 episodes from baseline) per 24 hours (p<.0001) in OAB patients who had a suboptimal response to tolterodine, 4 mg. The safety and tolerability profiles of fesoterodine and tolterodine were consistent with previous studies. The most common treatment-emergent adverse events for both fesoterodine and tolterodine were dry mouth and constipation.
“This study adds to the body of evidence supporting fesoterodine as an effective treatment for patients with overactive bladder, including patients who may not have responded to tolterodine,” said principal investigator Steven A. Kaplan, MD, of New York-Presbyterian Hospital/Weill Cornell Medical Center, New York. “Health care professionals often question how to treat patients who have had a suboptimal response to tolterodine, which is commonly used but does not have a dose higher than 4 mg, and these data may help to guide treatment decisions.”
Drug treatments for urge incontinence are used alongside bladder re-training.