It is an embarrassing medical problem that blights the lives of one in ten of us and can cause people to avoid social occasions for fear of an accidental ‘leak’.
But millions of Britons suffering from overactive bladder syndrome (OAB) could benefit from a new daily pill that has been given the green light by UK health officials.
VAH is a condition in which people frequently experience a sudden, uncontrollable urge to urinate, which can lead to soiling and even take over their lives.
It can be triggered by a variety of health conditions, from diabetes, physical pressure on the bladder from other organs or masses such as an enlarged prostate, neurological disease or infection.
But now the estimated 8 million Britons living with VAH could have a new lease on life after officials approved the drug vibegron.
Millions of Britons suffering from overactive bladder syndrome (OAB) could benefit from a new daily pill that has been given the green light by UK health authorities
Officials at the Medicines and Healthcare products Regulatory Agency (MHRA) have given the drug vibegron, sold under the brand name Obgemsa in the EU and Gemtesa in the US, approval for use in British patients with overactive bladder syndrome.
This daily pill, which costs around £13 each in places like the US, relaxes the bladder muscles, reducing the risk of leaks or sending a person to the toilet urgently.
Officials at the Medicines and Healthcare products Regulatory Agency (MHRA) have given the drug vibegron, sold under the brand name Obgemsa in the EU and Gemtesa in the US, approval for use in British patients with VAH.
They based this approval on evidence from a clinical trial in which 1,500 patients with VAH took the drug for 12 weeks.
One-third of the group received the drug, and the remaining two-thirds were split between receiving a placebo or nothing.
The results showed that those taking vibegron suffered less daily urination and incontinence.
Vibegron does not work as a cure, but rather relieves symptoms, meaning patients will need to take it continuously to enjoy its effects.
However, the MHRA’s decision does not mean that patients will be able to access medical care through their GP straight away.
An independent government-funded body, the National Institute for Health and Care Excellence (NICE), decides whether medicines are cost-effective enough to be provided through the health service.
NICE is still weighing up the merits of vibegron, meaning at best patients will only be able to access it privately in the UK after MHRA approval.
While no UK price has been announced, a one-month supply in the US costs around £408 ($530).
This would put the price of an annual supply of the drug at around £4,900.
The MHRA said the most common side effects of vibegron include diarrhoea, constipation, nausea, urinary tract infection, as well as an increase in urine remaining in the bladder after voluntary urination.
Officials added that, as is usual with any drug they approve, they will continue to constantly review its safety and efficacy.
VAH is a common condition because of the number of other diseases and health problems that can trigger it.
Women and older people are generally considered to be at higher risk for overactive bladder, in part because they are more likely to experience the problems that can trigger it.
Patients may also develop VAH as part of a “learned” habit from when they had a condition that triggered it, meaning they may still have symptoms years later.
Drinking liquids that can irritate the bladder, such as coffee, tea, carbonated drinks, and alcohol, as well as smoking, can exacerbate the symptoms of overactive bladder.
People with VAH may become socially isolated and withdrawn due to their fear of “leaking” and become nervous about leaving their home where they have easy access to a bathroom.
Even those who overcome this may still suffer from problems such as sleep disturbance due to repeatedly getting up during the night to urinate.
Patients with VAH are diagnosed by keeping track of how often they urinate and then undergoing a series of tests to determine the possible underlying cause.
Current NHS treatment options include bladder ‘training’ to stretch the bladder and help it hold more urine, and medications to relax the muscles of the organ similar to vibegron.
VAH is a condition in which people often suffer from a sudden, uncontrollable urge to urinate that can lead to soiling and take over their lives (file image)
While there are many medications available, they have differences in terms of side effects that can vary from person to person, meaning a patient may need to try several before finding the one that works best for them.
Some patients do not respond to any medication or suffer intolerable side effects, they may be offered an injection of Botox (botulinum toxin) to paralyze the bladder muscles.
Much like how Botox is used for cosmetic purposes to paralyze facial muscles in an attempt to stop wrinkles, the mechanism relaxes the muscles in the bladder, helping it to hold more urine.
The NHS says the treatment is effective in 85 per cent of patients who undergo it.
However, experts have previously warned that many people with VAH, especially older patients, do not seek help out of embarrassment or mistakenly view incontinence as a natural consequence of aging.