Fibromyalgia and have urge continence

[Guest Posts]

I suffer with Fibromyalgia and have urge continence and my bladder doesn’t completely empty. I’ve had no treatment for this so far. The problem is getting worse. What can I do? What treatments could I discuss with my doctor? Anna

[Mr Mohammed Belal]

Dear Anna

I have included the summary below that i have mentioned in a previous post. Lifestyle interventions and initial medication described below would be appropriate to discuss with your GP.


Overactive bladder is a common condition that affects over 12% of the population over the age of 40. The condition consists of the key symptoms of urgency. This is a sudden compelling desire to void which is difficult to defer. Red flag symptoms such as haematuria( blood in urine) need to be investigated first and a urine dipstick is an important test.
Initial treatment consists of lifestyle interventions such as reducing caffeinated drinks and acidic foods and excess fluid intake. This can be combined with bladder retraining. This is a program to retrain the bladder with gradually increasing voiding frequency. Filling a frequency volume chart is helpful to characterise what is drunk and what volumes of urine are passed.
Failure of lifestyle interventions may require the use of medication. These includes anticholinergics, beta 3 agonists. Anticholinergics such as oxybutynin and solifenacin, are effective in reducing the symptoms, though they are associated with side effects of dry mouth and constipation. Mirabegron is a beta 3 agonist, that is well tolerated though blood pressure has to be monitored periodically. This can be achieved in primary care
When these have failed in a minority of patients, more invasive therapy can be considered such as intradetrusor Botox and sacral neuromodulation can be considered. Intradetrusor Botox work effectively though it s effects are limited to 6 to 9 months that need to be repeated. Risks include recurrent utis and voiding difficulties. Sacral neuromodulation works well but risks include need to change the battery at 5 years and a need to revise in a minority of patients.
Rarely surgery such as a clam cystoplasty is required. In your case trying lifestyle intervention and perhaps medication may resolve your symptoms