Overactive bladder is the urological term for the symptom complex of urinary frequency, urgency (the need to rush to the toilet due to a sensation of needing to pass urine that is difficult to defer), and urge incontinence. There are many possble causes for these symptoms, and no one disease responsible.
The most common type of overactive bladder results from abnormal involuntary contractions of the bladder muscle, the cause for these is unclear despite a great deal of research. As the availability of human bladder muscle is reducing rapidly and the barriers to experimenting on it increasing, it is possible that we will never find the true cause.
Despite this we can do a great deal to modify and improve the symptoms. Treatment is directed at lifestyle measures, bladder retraining, a range of subtly different medications and lastly surgical interventions. We have a great deal of research and clinical experience in dealing with overactive bladder and are happy to see patients with this problem.
Blood in the urine and bladder cancer
Visible blood in the urine can be very worrying and always requires investigation. It may be a result of a number of problems, ranging from infection to bladder cancer. Early investigation is important, most urologists recommend at least a CT scan and endoscopic examination of the bladder (cystoscopy). We are able to arrange these diagnostic tests in comfortable facilities at the patients convenience. Cystoscopy can be performed under a general or local anaesthetic, with the later the patient experiences at worse only minor inconvenience and it is pain-free. The results will be communicated directly after, and the patient will be able to leave five minutes afterwards. The whole procedure generally takes no more than ten minutes, and the actual cystoscopy around two.
Non-visible blood in the urine is usually detected by the GP using urine dipsticks and is common in normal individuals. Despite often being normal it may also be a sign of either kidney disease or the same urological problems that cause visible haematuria and therefore requires investigation in patients with risk factors for these conditions.
Urinary tract infections are common in certain population groups. Some infections need no investigation and when isolated may be considered harmless, in some circumstances urinary infections can be very serious and be a sign of disease of the bladder or kidneys. Your GP will be able to advise you on which.
Cystitis generally refers to the symptoms of pain when passing urine and urinary frequency, and may be accompanied by feeling tired or unwell, smelly urine and sometimes blood in the urine. Cystitis is far more common in women than men, and when isolated may safely be treated by your GP with a short course of antibiotics. recurrent infections require at least an ultrasound and sometimes a cystoscopy.
Pyelonephritis is when a urinary infection spreads to the kidneys and can cause severe pain and a fever. Further investigation is always required to exclude a structural abnormality although no cause is found in a high percentage of cases.