Bladder disorders

As many as 17% of people over 40 have an overactive bladder (OAB). That is an estimated 22 million people in Europe and over 33 million Americans. If you have OAB, you get a frequent need to urinate. There is a sudden urgent need to urinate, that you cannot put off, which may be followed by urine leakage (urge incontinence). You probably need to go to the toilet a lot (eight or more times over a 24-hour period). You may have to get up at night too.

OAB – also called unstable bladder – happens because the bladder muscle does not work properly. It contracts too much and pushes urine out of the bladder even when it is not full.

Not surprisingly, people with OAB get very embarrassed about it. Some are afraid to go out in case they cannot get to a toilet in time. Many do not tell their family or friends, or even their doctor.

Treating bladder disorders

Overactive bladder is usually treated with medicines that stop the bladder muscle from contracting so much. This reduces the need to pass urine, so people do not have to keep going to the toilet, during the day and at night. And they are less likely to have embarrassing leaks.

The medicines for overactive bladder are called anticholinergic drugs. They work at places on the bladder muscle called muscarinic receptors.

These receptors are found in other parts of the body too, including the mouth, the intestines and the eyes. This means that anticholinergic drugs in tablet form used to treat OAB, though effective, may be associated with side effects like dry mouth, and constipation. Skin patch treatment for OAB delivers medication continuously into the blood stream. It avoids the transformation of the drug by the digestive system that occurs with pills. The anticholinergic side effects such as dry mouth and constipation, occurred no more frequently with the skin patch than with placebo in two studies. However, the most frequent side effects of the patch were pruritus and erythema limited to the application site.