If you have to keep running to the loo, but then pass very little urine, you could be one of the more than 400 million people worldwide who suffer from an overactive bladder (urge incontinence).

Overactive bladder (urge incontinence): Causes

Overactive bladder (urge incontinence) occurs when nerve signals to the bladder are overstimulated, causing the muscles to squeeze and contract in an uncontrolled fashion, creating an urge to urinate. This overstimulation of the nerves can be caused by an underlying neurological condition, such as a stroke, Parkinson’s disease, or multiple sclerosis.

However, there is another group of people who develop overactive bladder (urge incontinence) for whom the exact cause is never discovered.

Overactive bladder (urge incontinence): Current treatments

Overative bladder (urge incontinence) is often first treated using conservative methods – like lifestyle changes and pelvic floor exercises – before medication is given.

If the problem persists, treatments such as botox, electrical stimulation, or surgery are considered, said Dr Tricia Kuo, Consultant, Department of Urology, Sengkang General Hospital (SKH), a member of the SingHealth group.

Overactive bladder (urge incontinence): New nerve stimulation treatment 

For those who prefer less invasive methods, a relatively new procedure that doesn’t involve surgery and whose effects are fairly enduring is now available in Singapore. Known as percutaneous tibial nerve stimulation, the treatment is similar to acupuncture and is done in the clinic, said Dr Kuo.

“A fine (0.18mm in diameter) needle electrode is inserted 10mm to 20mm deep into the skin near the ankle to stimulate a specific nerve that transmits signals to the bladder. With a small electrical current, the muscles controlling the bladder can be regulated,” said Dr Kuo.

The procedure, offered at SGH since April 2015, takes about 30 minutes each time. A complete course involves 12 visits over three months and provides relief for up to two years.

“After the initial 12 weeks of treatment, the frequency of treatment is tapered down,” she said, adding that patients can have treatment intermittently after that.

Apart from the sensation from the needle prick, the side effects of percutaneous tibial nerve stimulation are mild, brief and relatively rare. The procedure is mainly used to treat urinary incontinence – overactive bladder or urge incontinence – but in select cases can be used to treat faecal incontinence.

Overactive bladder (urge incontinence) is not part of ageing!

With the wide range of treatment options available, people who experience overactive bladder (urge incontinence) should seek help once they develop symptoms that become bothersome or which start to affect daily life, said Dr Kuo.

“Prevention is not always possible since even normal childbirth can lead to incontinence in later years. But this should never be accepted as a normal part of ageing,” said a former Senior Consultant, Department of Colorectal Surgery, Singapore General Hospital (SGH), and Director, SGH Pelvic Floor Disorders Service.

Read on to learn about more treatments for an overactive bladder (urge incontinence).