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Q. I feel bladder fullness with increased urine frequency at night. Do I have an overactive bladder?

Answered by
Dr. Samer S J Altawil
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 09, 2020

Hi doctor,

I have had an overactive bladder for around five to six years. I would like to find out what the issue is and if I have any health concerns. I have never had a bladder infection and have been tested many times. I had one C section last year, but it did not make my condition worse.

My symptoms are, I urinate two liters in 24 hours and go around 8-11 times. 2-3 times in the night. And my bladder is always full. Sometimes when I go, it does not feel empty straight after. So I have to go again. I do not have pain. Occasionally a slight burning like irritation inside the urethra. I feel like I produce too much urine. It is breaking my sleep and making me quite tired sometimes. I want to find out what is wrong. Please help.

#

Hi,

Welcome to icliniq.com.

Overactive bladder is diagnosed with urodynamic studies. You have symptoms of increased frequency of urine, mainly at night, causing sleep disturbance. Careful investigations and follow up required. As long as we get the cause, then only treatment will be effective.

Do you have long term problems like diabetes or hypertension? Are you on any medications in the long term other than you take for your bladder problem? How is your sleep recently? Is it enough or have difficulty sleeping due to the frequency of urine at night? Have you ever undergone a cystoscopy?

Investigations:

1. Urine analysis.

2. Ultrasound KUB (kidney, ureter, and bladder).

Maintain bladder diary for two days (record what time you go toilet and how much urine you pass each time for 24 hours). This will enable me to have a proper diagnosis before I start you on medications.

Thank you doctor,

I have attached two days diary for you of how much urine I passed. Each day is similar but can vary sometimes, some nights can be quite bad, but others not so. I have had urine sent off to a lab before, and all came back, so I guess that was a urine analysis about four years ago along with a diabetes test, which came back fine too.

I have had no other tests like scans or anything. I was offered a diabetes insipidus test but declined four years ago. I feel more thirsty towards the end of the day. And I seem to produce a lot of saliva at the start of the night. No hypertension. My sleep is bad, but I also have a baby and rhinitis but not diagnosed. And then the frequent urination on top of that does make me tired. No long term medications. Occasional steroid nasal spray for my allergies.

#

Hi,

Welcome back to icliniq.com.

The bladder diary was valuable. I can see that the bladder capacity is smaller than normal the maximum urine volume was 300 ml, but normal is supposed to be 450 ml. The frequency at night is more observed. And the frequency is ranging from two to four hours, which is normal. The diagnosis is the most properly overactive bladder. A urodynamic study can make a definitive diagnosis. But it is an invasive test and requires you to go to the hospital.

Instructions:

1) Avoid tea, coffee, and fizzy drinks.

2) Avoid high potassium-containing foods like a banana.

3) Drink about 2-2.5 liters per day no more.

4) Reduce fluids/ no fluids two hours before bed.

5) Pass urine immediately before bed.

6) Tablet Tolterodine 4 mg once at night.

Please follow up after four weeks with a bladder diary again and update me about your condition.


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