Many people think that frequent bathroom visits are a natural part of aging. But that is not true. As many as eight to 10 million South Africans could be affected by Overactive Bladder (OAB), a disease not much talked about but as common as hay fever or high cholesterol, according to Professor Mohamed Haffejee, the head of the department of urology at the University of the Witwatersrand.

The symptoms of OAB can occur day and night. They include: Frequent, sudden urges to urinate — going more than eight times in 24 hours, which may include getting up at night, and in some instances, wetting or leaking accidents.

Often not addressed

It's a condition seldom addressed by medical practitioners. Patients are not aware that this condition exists and that they suffer from it. And, because of its potentially embarrassing nature, they don't talk about it with their doctors. The good news is that OAB is a real medical condition that can be treated.

Professor Haffejee says OAB is not normal at any age. It affects male and female patients alike and often starts in the 30s or 40s, but is more prevalent in later years.

The spectrum of OAB ranges from dry to wet incontinence. Dry incontinence means that people with this condition tend to urinate more than eight times per day, have a sense of urgency to do so and find it difficult to postpone.

Wet incontinence is worse as it can involve urine leakage throughout the day. Not all leakage is necessarily the same. Some people experience a strong, uncontrollable urge to pass urine and if they do not go to the toilet are likely to have an 'accident'.

Then there is stress urinary incontinence often brought on by pregnancy, sneezing or coughing. Sometimes there is a combination of both. Kegel exercises can help to strengthen pelvic floor muscles to overcome wet or dry incontinence.

Train your bladder

Bladder training starts at a young age. Many people habitually respond to certain stimuli. For example, they need to go before a car trip, a meeting or a movie. All it takes for these people is to retrain their bladders by increasing the intervals between toilet visits. Four hour intervals are normal, but of course fluid intake plays a major role. Bladder retraining and fluid management are key to overcoming dry incontinence.

"Anti-cholinergic agents, such as Pfizer’s Detrusitol, are very effective for those patients where bladder retraining is not enough. This medicine helps calm the bladder muscle that causes those frequent, sudden urges. Just one pill works for 24 hours to relieve symptoms throughout the day and night. Anti-cholinergics have few side-effects and are fairly safe to use over the long-term," Prof Haffejee says.

The majority of patients do well on a combination of bladder training and medication. Some patients discontinue the anti-cholinergic medication once their bladder has been successfully retrained; others may need to take the medicine on an ongoing chronic basis.

Quality of life

Professor Haffejee says, "the real issue at hand is quality of life. For older, frailer patients, frequent nightly visits to the bathroom pose an unnecessary risk for falls and bone fractures, and in the case of wet incontinence, patients become predisposed to developing skin rashes".

For the few patients where bladder retraining and anti-cholinergic medication did not work, Botox can be used to calm the bladder muscles. Another option is sacral neuromodulation, a type of pacemaker for the bladder, and a last resort would be surgical augmentation of the bladder.

For more information about Overactive Bladder, phone Pfizer's OAB Helpline on 0860 734 937 or visit www.overactivebladder.co.za.