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Overactive Bladder

September 9, 2022

Do you feel an urgency to urinate when the bladder is filled? Are you getting up multiple times at night for urination? Are you able to resist urination if the restroom is occupied? Do you leak while sneezing/laughing? 

If any of the answers is a YES, it can be one of the symptoms of overactive bladder syndrome. Overactive bladder syndrome or OAB is a symptom and signs-based syndrome, marked by urinary urgency and increased frequency, nocturia (frequent nighttime urination) & urinary incontinence.

Book an Appointment with Ms.Prachi Tikkha Saraswat for all you Physiotherapy consultations.


The syndrome can occur because of multiple reasons- 

  • Pelvic floor muscle weakness - The pelvic floor or pelvic diaphragm is composed of muscle fibres of the levator ani, the coccygeus muscle and associated connective tissue which span the area underneath the pelvis. During pregnancy and post-delivery, the pelvic floor muscles lose strength which can lead to OAB. 
  •  Neurological reasons - various neurological disorders may influence the nerves and thus the sensations are not accurate, leading to wrong impulses and signals being sent to the brain and bladder. 
  • Alcohol & Caffeine intake - people who consume high levels of alcohol and caffeine-rich beverages like coffee, tea, etc. are more prone to develop OAB.
  • Other lifestyle issues - Ladies are more prone to develop OAB post-menopause, and people who have higher BMI are more prone to develop OAB as excess weight puts extra pressure on the bladder. 

Also Read : Tinkle Troubles: How to Break Free from Urinary Incontinence

Signs & Symptoms 

  • Urinary urgency - Not able to resist urination when in need.
  • Urge incontinence - This symptom is marked as having leakage, if urine urgency. 
  • Nocturia - This symptom is characterized by getting up multiple times at night for urination.
  • Frequency of urination - This marks the number of times a person needs to urinate. With OAB the frequency is higher.


The treatment for this syndrome must be done under an OBG-GYN physiotherapist, it involves easy lifestyle changes, bladder training and training pelvic floor muscles.

  • Lifestyle changes 

It involves maintaining a healthy diet, limiting the amount of alcohol and caffeine-rich products, reducing weight and sustaining a healthy BMI

  • Bladder retraining

This is a combination of several behavioral changes that a person needs to incorporate till the condition is completely treated. If a person is suffering from OAB, over time, the bladder is conditioned and may have to retrain it. Maintaining a Bladder diary, mentioning the frequency, time, night frequency and events that lead to urine urgency. Timely voiding of urine (urinate according to timetable) are a few of the examples that an OBG-GYN physiotherapist may advise for bladder retraining. 

  • Strengthening pelvic floor muscles 

Kegels are the first exercises that are used to strengthen the pelvic floor muscles. To perform Kegels, it is important to understand how to find pelvic floor muscles, for identification, while urinating, stop the flow midstream, hold for 3 seconds, relax and allow the flow to continue to repeat a few times to understand the right muscle to squeeze/tighten and relax. Remember this is just a test or a way of understanding Pelvic floor muscles.

Kegels can be done in any position, standing/sitting/lying down and anytime without anyone knowing about it. One just needs to contract/tighten vaginal muscles and relax as if trying to stop urine, which must be done with an empty/relaxed bladder. Breathing must not be affected while doing so. If done correctly, meaning from back to front, a gentle contraction is felt in the lower abdominal muscle. It is also equally important to relax/lengthen/release the pelvic floor muscle. 

Overactive bladder is a symptoms-based syndrome, that's the reason being that it should be treated as soon as it is identified so that the person is not habituated and accustomed to the abnormal pattern. If anyone notices any such symptoms, one must address it to the gynecologists' and the appropriate treatment must be provided. 

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