Overactive Bladder and Urgency in Maltese

What is overactive bladder?

The bladder is a muscle which contracts to empty the bladder when it is full and you are ready to empty. An overactive bladder means the bladder contracts before it is full. It can sometimes contract when you are not ready. You might go to the toilet often and find it hard to hold on until you get there. At times you may leak urine on the way to the toilet.

X’inhi bużżieqa attiva żżejjed?

Il-bużżieqa tal-awrina hija muskolu li jinġibed biex titbattal il-bużżieqa tal-awrina meta tkun mimlija u inti tkun lest/a biex tbattal. Bużżieqa tal-awrina attiva żżejjed tfisser li l-bużżieqa tinġibed qabel ma tkun mimlija. Kultant tista’ tinġibed meta inti tkun gћadek mhux lest/a. Int tista’ tmur it-tojlit spiss u ssibha bi tqila biex iżżomm sakemm tasal hemm. Xi kultant inti tista’ tqattar l-awrina kif tkun sejjer/sejra t-tojlit.

What causes overactive bladder?

Poor bladder control may be due to health problems, such as:

• stroke.
• having an enlarged prostate gland.
• Parkinson’s disease.

An overactive bladder can be due to poor bladder habits over a long time.

For some people the cause is unknown.

X’jikkawża bużżieqa tal-awrina attiva żżejjed?

Kontroll dgћajjef tal-bużżieqa tal-awrina jista’ jkun ġej minn problemi tas-saћћa, bћal:

• puplesija.
• glandola imkabbra tal-prostat.
• il-marda ta’ Parkinson.

Il-bużżieqa tal-awrina attiva żżejjed tista’ tkun minћabba drawwiet ћżiena fuq medda ta’ żmien twil.

Gћal xi ftit min-nies il-kawża mhijiex magћrufa.

What are normal bladder habits?

It is normal to:

• empty your bladder when you get out of bed in the morning.
• empty your bladder about 4 to 6 times through the day.
• empty your bladder before you go to bed at night.

A healthy bladder holds about 1.5 to 2 cups of urine. This is equal to 300 - 400mls. Your bladder holds this much during the day. It holds more during the night, before you feel the need to pass urine.

This pattern may change in older people. Older people may make more urine at night. This means they may have to pass more urine through the night than they do in the day.

X’inhuma d-drawwiet normali tal‑bużżieqa tal‑awrina?

Hija ћaġa normali li:

• tbattal il-bużżieqa tal-awrina tiegћek malli toћroġ mis-sodda filgћodu.
• tbattal il-bużżieqa tal-awrina tiegћek madwar 4 sa 6 darbiet matul il-jum.
• tbattal il-bużżieqa tal-awrina tiegћek qabel ma tidћol fis-sodda filgћaxija.

Bużżieqa tal-awrina b’saћћitha żżomm madwar 1.5 sa 2 kikkri awrina. Dan huwa ugwali gћal 300 – 400mls. Il-bużżieqa tal-awrina tiegћek iżżomm dan matul il-jum. Iżżomm aktar matul il-lejl qabel ma tћoss il-bżonn biex tgћaddi l-awrina.

Dan ix-xempju jista’ jinbidel f’nies ta’ età ikbar. L-anzjani jistgћu jagћmlu aktar awrina bil-lejl. Dan ifisser li jista’ jkollhom jgћaddu aktar awrina bil‑lejl milli matul il-ġurnata.

What is bladder training?

The aim of bladder training is to improve symptoms of overactive bladder. Bladder training teaches you how to hold more urine in your bladder without feelings of urgency. Visit your doctor, a continence nurse advisor or continence physiotherapist if you have some problems with bladder control. They could start you on a bladder training program. If you do nothing about your problem, it may get worse.

X’inhu l-eżerċizzju tal-bużżieqa tal-awrina?

Il-mira tal-eżerċizzju tal-bużżieqa tal-awrina hija li jtejjeb is-sintomi tal-bużżieqa tal-awrina attiva żżejjed. L-eżerċizzju tal-bużżieqa tal-awrina jgћallmek kif iżżom aktar awrina fil-bużżieqa tal‑awrina tiegћek mingћajr ma tћoss l-urġenza. Jekk gћandek xi problemi bil-kontrall tal-bużżieqa tal-awrina mur gћand it-tabib tiegћek, ners konsulent/a dwar il‑kontinenza jew fiżjoterapista tal-kontinenza. Huma jistgћu jibdewk fuq programm tal-eżerċizzju tal-bużżieqa tal-awrina. Jekk ma tagћmel xejn dwar il-problema tiegћek tista’ tmur gћall-agћar.

What is in a bladder training program?

You may be asked to keep a bladder diary. You need to keep the diary for at least 3 days. It keeps track of how your bladder works through the day.

The bladder diary keeps track of:

• the time you go to the toilet.
• how much urine you pass each time.
• how strong you felt the urge to empty each time.

The bladder diary may look something like this:

X’hemm fi programm tal-eżerċizzju tal‑bużżieqa tal-awrina?

Tisata’ tkun mitlub/a biex iżżomm djarju tal-bużżieqa tal-awrina. Int tinћtieġ iżżomm id-djarju gћal talinqas 3 ijiem. Dan iżomm il-kors ta’ kif taћdem il-bużżieqa tal-awrina tiegћek matul il-jum.

Id-djarju tal-bużżieqa tal-awrina jżomm il-kors ta:

• l-ћin li tmur it-tojlit.
• kemm tgћaddi awrina kull darba.
• kemm kienet qawwija l-urġenza li ћassejt kull darba biex tbattal.

Id-djarju tal-bużżieqa tal-awrina jista’ jkun jidher xi ћaġa bћal dan:

How do I measure the amount of urine passed?

Put a container (like an ice cream container) in the toilet. Now sit on the toilet and relax with your feet on the floor. Pass urine into the container. Then tip the urine into a jug to measure it. Men may want to stand and pass urine directly into a measuring jug.

How do I measure urgency?

This chart shows how to use a number to describe the urge you felt.

Kif inkejjel l-awrina li nkun gћaddejt?

Poġġi kontenitur (bћal kontenitur tal-ġelat) fit-tojlit. Issa oqgћod bilqegћda u rrilassja b’saqajk fuq l-art. Agћmel l-awrina fil-kontenitur. Imbagћad itfa’ l-awrina f’buqar biex tkejjilha. L-irġiel jistgћu jkunu jridu joqogћdu bil-wieqfa u jgћaddu l-awrina direttament fil-buqar tal-kejl.

Kif inqis l-urġenza?

Din iċ-ċart turi kif tuża numru biex tiddeskrivi l-urġenza li tkun ћassejt.

How do I measure leaking using a Pad Weight Test?

This test helps to work out how much urine you leak over a few days. To do this test you will need some accurate scales for weighing. You do this test by:

1. weighing a dry pad in a plastic bag before you wear the pad,
2. then weighing the wet pad in a plastic bag after you wear it, and
3. taking the weight of the dry pad away from the weight of the wet pad.

This will show how much you have leaked because each gram equals one ml.

Like this:

Kif nikkalkula t-taqtir billi nuża it-Test tal-Piż tal‑Pads (Pad Weight Test)?

Dan it-test jgћin biex tikkalkula kemm tqattar awrina matul xi ftit ġranet. Biex tagћmel dan it-test tkun tinћtieġ xi miżien preċiż biex tiżen. Inti tagћmel dan it-test billi:

1. tiżen pad nixfa f’borża tal-plastik qabel ma tilbes il-pad,
2. imbagћad tiżen il-pad imxarrba f’borża tal-plastik wara li tkun ilbistha, u
3. tnaqqas il-piż tal-pad nixfa mill-piż tal-pad imxarrba.

Dan juri kemm tkun qattart gћax kull gramma hija ugwali gћal ml wieћed.

Bћal hekk:

Who can help with your bladder training program?

A doctor, continence nurse advisor or continence physiotherapist can get the best results for you. They will work out a program to suit you.

Some of these continence health professionals may be in a private practice clinic. Others work in clinics in your local community health service. They also work in public hospital clinics. The National Continence Helpline 1800 33 00 66 can help you find your local continence clinic.

Min jista’ jgħin bil-programm tal‑eżerċizzju tal-bużżieqa tal‑awrina tiegħek?

Tabib, ners konsulent/a tal-kontinenza jew fiżjoterapista tal-kontinenza jistgћu jiksbu l-aћjar riżultati gћalik. Huma jћejju programm li jkun jgћodd gћalik.

Xi wћud minn dawn il-professjonisti tas-saћћa dwar il-kontinenza jistgћu jkunu fi klinika ta’ prattika privata. Oћrajn jaћdmu fil-kliniċi fis-servizz kominitarju tas‑saћћa lokali tiegћek. Huma jaћdmu wkoll fil-kliniċi tal-isptarijiet pubbliċi. Il-Linja Nazzjonali tal-Gћajnuna bit-telefown dwar il-Kontinenza (National Continence Helpline) 1800 33 00 66 tista’ tgћinek biex issib il‑klinika tal-kontinenza lokali tiegћek.

How long will it take?

Most bladder training programs take about 3 months. You may have regular meetings with your continence nurse advisor or continence physiotherapist. They will teach you ways to hold on for longer. This will mean you can hold more urine in your bladder.

Kemm idum?

Il-biċċa l-kbira tal-programmi tat-taћriġ jieћdu madwar 3 xhur. Inti jista’ jkollok laqgћat regulari man-ners konselunt/a dwar il-kontinenza jew mal-fiżjoterapista tal-kontinenza. Huma jgћallmuk modi ta’ kif iżżomm l-awrina gћal iktar fit-tul. Dan ifisser li tkun tista’ iżżom aktar awrina fil-bużżieqa tal-awrina tiegћek.

Some helpful things you will learn from the program

Pelvic Floor Muscle Training

The continence physiotherapist or continence nurse advisor will teach you how to use your pelvic floor muscles. These muscles support your bladder and urethra. The urethra is the tube that carries urine from the bladder to the outside. Strong pelvic floor muscles help to hold back the strong urge to pass urine. This will help you hold on until you reach the toilet.

Good Bladder Habits

It is normal to consume between 1.5 - 2 litres of fluid per day unless your doctor says this is not okay. This way your bladder will slowly learn to stretch to hold more urine. You need to keep track of how much you drink each day. To do this you will need to know how much your cup or mug holds. Cups can hold from 120 to 180mls whereas mugs can hold 280 to 300mls or more.

Avoid drinking fizzy drinks or drinks with caffeine. These can upset the bladder and make it harder for you to hold on. There is some caffeine in chocolate, tea and coffee. There is more caffeine in cola and sports drinks. It is best to avoid drinking these.

You will learn which drinks to choose so your bladder will not be upset.

Good Bowel Habits

You will also learn how constipation and straining to pass a bowel motion can stretch your pelvic floor muscles. Avoid constipation as this also causes poor bladder control. Eat at least 2 pieces of fruit and 5 serves of vegetables daily. Eat high fibre bread as well.

Xi affarijiet utli li ser titgħallem mill‑programm

Eżerċizzju tal-Muskolu tal-Qiegћ tal-Pelvi

Il-fiżjoterapista tal-kontinenza jew in-ners konsulent/a dwar il-kontinenza jgћallmuk kif tuża il-muskoli tal-qiegћ tal-pelvi tiegћek. Dawn il-muskoli jissapportjaw il-bużżieqa tal-awrina u l-uretra tiegћek. L-uretra hija t-tubu li jġorr l-awrina mill-bużżieqa tal-awrina gћal barra. Muskoli tal-qiegћ tal-pelvi b’saћћithom jgћinu biex inaqqsu l-urġenza qawwija biex tgћaddi l-awrina. Dan ser jgћinek iżżomm sakemm tasal it-tojlit.

Drawwiet Tajbin Tal-Bużżieqa Tal-Awrina

Huwa normali li tixrob bejn 1.5 – 2 litri ta’ likwidi kuljum gћajr jekk it-tabib tiegћek jgћidlek li dan mhuwiex tajjeb. Hekk il-bużżieqa tal-awrina tiegћek ser titgћallem bil-mod tinġibed biex iżżomm aktar awrina. Inti trid iżżomm kont ta’ kemm tixrob kuljum. Biex tagћmel dan inti trid tkun taf kemm tesa’ l-kikkra jew il-magg tiegћek. Il-kikkri jistgћu jesgћu minn 120 sa 180mls waqt li l-maggs jistgћu jesgћu minn 280 sa 300mls jew iżjed.

Skarta milli tixrob xorb ifexfex jew li jkun fih il‑kafeina. Dawn jistgћu jirritaw il-bużżieqa tal-awrina u jagћmluha iktar iebsa gћalik biex iżżomm. Hemm ftit kafeina fiċ-ċikkulata, fit-te u fil-kafè. Hemm iktar kafeina fix-xorb tal-cola u tal-isports. L-aћjar huwa li tiskarta milli tixorb dan ix-xorb.

Int ser titgћallem liema xorb tagћżel biex ma tirritax il-bużżieqa tal-awrina tiegћek.

Drawwiet Tajbin tal-Imsaren

Inti ser titgћallem ukoll kif il-kostipazzjoni u t-tqanżiћ biex tipporga jistgћu jistiraw il-muskoli tal-qiegћ tal‑pelvi tiegћek . Evita il-kostipazzjoni gћax din tikkawża wkoll il-kontroll dgћajjef tal-bużżieqa tal‑awrina. Kul talanqas żewġ biċċiet frott u 5 porzjonijiet ta’ ћaxix kuljum. Kul ukoll ћobż bil-fibre.

Will there be setbacks?

Do not be worried by small day to day changes in your bladder control. These are normal. Anyone on a bladder training program can have setbacks, when your symptoms may seem worse. This may happen when:

• you have a bladder infection (see your doctor right away).
• you are tired or run down.
• you are worried or stressed.
• the weather is wet, windy or cold.
• you are ill (such as a cold or the flu).
• you are a menstruating woman.

If set-backs do happen, do not lose heart. Stay positive and keep trying.

Ser ikun hemm intoppi?

Tinkwetax dwar tibdiliet żgћar minn jum gћal jum fil‑kontroll tal-bużżieqa tal-awrina. Dawn huma normali. Kwalunkwe persuna li tkun qed tagћmel programm tal-eżerċizzju tal-bużżieqa tal-awrina jista’ jkollha intoppi, meta s-sintomi jidhru li marru gћal agћar. Dan jista jiġri meta:

• int ikollok infezzjoni tal-bużżieqa tal-awrina (ara t-tabib tiegћek minnufih).
• int tkun gћajjien/a jew debboli.
• int inkwetat jew stressjat.
• ikun temp tax-xita, bir-riћ jew il-bard.
• Int ma tiflaћx (gћandek riћ jew l-influwenza).
• Tkun mara bil-menstruwazzjoni.

Jekk ikollok l-intoppi, taqtax qalbek. Ibqa’ pożittiv/a u ibqa’ pprova.

Seek help

You are not alone. Poor bladder and bowel control can be cured or better managed with the right treatment. If you do nothing, it might get worse.

Phone expert advisors on the National Continence Helpline for free:

• advice;
• resources; and
• information about local services

1800 33 00 66 *

(8am - 8pm Monday to Friday AEST)

To arrange for an interpreter through the Telephone Interpreter Service (TIS), phone 13 14 50 Monday to Friday and ask for the National Continence Helpline. Information in other languages is also available from continence.org.au/other-languages

For more information:

• continence.org.au
• pelvicfloorfirst.org.au
• bladderbowel.gov.au

* Calls from mobiles are charged at applicable rates.

Itlob l-għajnuna

M’intix waћdek. Kontroll dgћajjef tal-bużżieqa tal-awrina u tal-imsaren jista’ jkun ikkurat jew immaniġġjat aћjar bil-kura xierqa. Jekk ma tagћmel xejn tista’ tmur gћall-agћar.

Ċempel lill-konsulenti esperti fuq in-National Continence Helpline bla ћlas:

• parir;
• riżorsi; u
• informazzjoni dwar servizzi lokali.

1800 33 00 66 *

(8am - 8pm mit-Tnejn sal-Ġimgћa AEST)

Biex tirranġa gћal interpretu permezz tas-Servizz Telefoniku tal-Interpretu (TIS) ċempel 13 14 50 mit‑Tnejn sal-Ġimgћa u saqsi gћan-National Continence Helpline. Informazzjoni f’lingwi oћra hija disponibbli wkoll f’ continence.org.au/other-languages

Gћal aktar informazzjoni:

• continence.org.au
• pelvicfloorfirst.org.au
• bladderbowel.gov.au

* Telefonati minn mobajls ikunu ċċarġjati bir-rati applikabbli.