Doc Botoxed bladder of woman who went to toilet 15 times daily

Cecilia, who suffers from an overactive bladder, said she sometimes wakes up four times a night to use the loo.

While talking to a client, she was struggling to fight against the urge to urinate.

That incident, coupled with the inability to concentrate at work, made the 59-year-old quit her part-time job at a bank three years ago. The housewife, who wanted to be known as Cecilia, is now undergoing treatment for an overactive bladder.

Those diagnosed with this condition usually need to urinate more than eight times a day, according to Dr Colin Teo, who heads the urology department at Khoo Teck Puat Hospital (KTPH).

"I felt like a prisoner in my own home," Cecilia said of the days she would isolate herself from others because of her condition.

According to newly released data from KTPH, there was a 150 per cent surge in the number of patients with overactive bladders from 2012 to 2014.

The average age for men diagnosed with this condition is about 60 years old. For women, it is 62.

As the symptoms of having an overactive bladder is similar to that of urinary tract infections (UTI), there is a higher tendency for patients to be misdiagnosed, Dr Teo said.

Cecilia, too, had been diagnosed with UTI before she sought a second opinion from a urologist in private practice.

She said the first symptoms started three years ago when she found herself making 15 trips to the toilet every day, despite drinking the same amount of water.

"I found myself holding back while meeting and conversing with people because I just couldn't cut people off abruptly," she said.

Cecilia's condition meant she also suffered from nocturia, a symptom where a patient has to wake up at night often to pass urine.

"I would usually wake up more than four times a night. Because of that, I didn't feel I had enough rest. At work, I couldn't complete tasks within the deadline," she said.

This was despite trying not to drink too much water before she slept.

It took Cecilia six months before she was properly diagnosed.

She said she felt mentally unprepared in case it was a serious problem, but she eventually decided to put her family's mind at ease. "I didn't highlight (my problem) to my family because I didn't want them to worry," said Cecilia, who lives with her children.

'ANTI-SOCIAL'

"I was feeling very down, actually. I became anti-social. I isolated myself and kept family outings to a minimum. If there was a need to be out of the house, I would always ensure there was a restroom nearby."

At one point, she would leave her home only to pray in church for her condition to improve.

Her children noticed her frequent trips to the toilet and urged her to go to a clinic.

Cecilia's treatment was delayed because a general practitioner had initially misdiagnosed her with UTI.

The housewife then consulted Dr Peter Lim, a urologist in private practice, for a second opinion. He diagnosed her with having an overactive bladder.

Cecilia first tried oral medication prescribed by Dr Lim to keep the symptoms under control.

She said: "The medicine did not eradicate my symptoms. It only minimised them and I do get intermittent flare-ups.

"After some time, when the symptoms did not go into full remission, (the doctor) proposed Botox as an alternative," Cecilia said.

Botox, which is popular in aesthetic medicine as a way to erase wrinkles, can also help relax the bladder muscle so that sudden contractions are minimised.

In September last year, the use of this drug was approved by the Health Sciences Authority to treat those with overactive bladders. Cecilia has gone for two Botox treatments, with a six-month interval in between each treatment.

"(Botox) put my symptoms into remission for a few months. (I've been advised) to go for another treatment again when it gets bad and unbearable, but the decision is up to me," she said.

Coping with her condition also means Cecilia has to do away with some of her favourite food and drinks, including green tea, which is a diuretic and makes her urinate more frequently.

"It's not a big lifestyle change, and (at least) I can have peace of mind."

KTPH: Cases on the rise

The number of patients with overactive bladders has soared from 121 in 2012 to 302 in 2014, according to data from Khoo Teck Puat Hospital.

It is a medical condition that can only be defined by its symptoms, said Dr Colin Teo, who heads the hospital's urology department. This is because not much is known about it, including its cause.

Dr Peter Lim, a urologist in private practice, defines it as a condition where the bladder muscles contract without a person's permission.

Some symptoms include frequent urination, feeling sudden uncontrollable urges to go to the toilet, and waking up at night to urinate.

"Some patients think their frequent urination is 'normal' because they are so used to it. They don't realise the number of times they go to the restroom is different from that of a healthy person," said Dr Teo.

While it can be treated completely, Dr Teo pointed out that patients may suffer a relapse.

Patients can modify their lifestyle, such as always making sure they are near a restroom when they're outside, or go for surgery.

Of the 945 patients at KTPH over the past four years, about 70 per cent failed to respond to "conservative measures" like lifestyle modifications and short-term medication.

fjieying@sph.com.sg


This article was first published on May 04, 2015.
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