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Urge incontinence (overactive bladder syndrome)

Urge urinary incontinence, also known as an overactive bladder or overactive bladder syndrome, is a very distressing condition as it is so unpredictable.


The initial approach is to try to avoid things that irritate the bladder and try to establish better urinary control. This normally involves avoiding caffeinated drinks, keeping your bowels regular and practicing pelvic floor exercises and bladder drill.


Bladder drill is a method of gradually increasing the amount of urine that the bladder can hold over a period of time with the aim of reducing the urgency symptoms and controlling the number of times that you have to go to the toilet to pass urine.

Sometimes these simple measures will be enough to regain control over your bladder but often a little extra help from medication is needed. There are 2 main groups of drugs that are used – anticholinergics (eg tolterodine, solifenacin) and a new class of drug called a beta-3-agonist (mirabegron). Once you have regained control of your bladder then you may well be able to stop the medication.

Well over 90% of patients with urge symptoms will respond to these treatments but there are other options for those who do not get sufficient relief. Other options include PTNS (Peripheral Tibial Nerve Stimulation), Botox injections into the bladder, Sacral Neuromodulation and more complex surgical options. We can discuss the advantages and disadvantages of each approach with you and help you decide what is best for you.


Bill McAllister

Martin Nuttall

Karan Wadhwa

Danny Swallow

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British Association of Urological Surgeons
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