You may be struggling with urinary symptoms and think overactive bladder (OAB) is the cause. Or, your health care provider may have already told you that you have OAB. Either option, this site will give you the tools and information to help you understand and better manage your condition.
You may also want to access our OAB Interactive Patient Guide. This web-based tool will take you through the entire journey from understanding OAB to taking control and finding treatment.
What is Overactive Bladder
If you've ever had that "gotta go" feeling, or the sudden urge to urinate that you cannot control or make you feel that you won't make it to the bathroom in time, you may have overactive bladder. This strong urge is one of the main signs that you may be living with overactive bladder (OAB). This is different from "stress urinary incontinence," or "SUI," when you leak urine while sneezing, laughing or other physical effort. You can learn more about SUI at www.UrologyHealth.org/SUI.
Overactive bladder is the name for a group of urinary symptoms. There are three main symptoms:
- A sudden feeling that you have to go to the bathroom, right away (this is the most common symptom of OAB).
- A leak of urine (known as incontinence) with the "gotta go" feeling. Some people may leak just a few drops, while others can have a sudden gush.
- A need to go to urinate often (frequently), day and night.
With OAB, you feel that you need to go to the bathroom – even when your bladder may not be full. This leads to the feeling that you need to empty your bladder, right now. You can't control or ignore this feeling. If you "gotta go" eight or more times each day and night, or fear that urine will leak out before you're ready, you may have OAB.
This "gotta go" feeling has many women running for the bathroom multiple times per day. This urge may be accompanied by urine leakage in some cases.
Who Gets OAB?
- Both men and women get OAB. In fact, OAB affects millions of Americans. As many as 30 percent of men and 40 percent of women in the United States live with OAB symptoms.
- Older women who have gone through menopause ("change of life") and men who have had prostate problems are more likely to get OAB.
- Growing older is a factor, but not all people get OAB as they age. It's not a normal part of aging.
- People with diseases that affect the brain or spinal cord (nervous system) such as stroke and multiple sclerosis (MS) are more likely to get OAB.
What Causes OAB?
Overactive bladder typically occurs when nerve signals between your bladder and your brain tell your bladder to empty even when it is not full and the bladder and pelvic floor muscles are not in coordination. OAB can also occur when the muscles in your bladder are too active or contract when they are not meant to, creating that sudden and strong urge to urinate. This is called "urgency."
Common Causes of OAB
There are a number of risk factors or common causes of OAB, including:
- Increasing age
- Back issues/surgery
- Obesity and being overweight
- Neurological conditions that affect the brain and spine including diabetes, multiple sclerosis, Parkinson's disease, stroke, cerebral palsy and spinal cord injury
- Bladder tumors, stones and infections
- Certain medications such as diuretics, sedatives and antidepressants
- Certain foods such as caffeine, alcohol and spicy foods worsen symptoms
OAB does not cause pain. If you feel pain while urinating, you may have an infection. Please talk with your health care provider about pain.
OAB Treatment Options
OAB symptoms may make it hard to get through your day without many trips to the bathroom. You may even cancel activities because you're afraid of being too far from a restroom. OAB can get in the way of your work, social life, exercise and sleep. Your symptoms may make you feel embarrassed and afraid of being wet in public. You may be tired from waking at night or feel lonely from limiting social activities. If you are leaking urine it may cause skin problems or infections.
You don't have to let OAB symptoms control your life. There are treatments to help. If you think you have OAB, please see your health care professional.
There are a number of treatments that can help you manage the symptoms of OAB and provide you with freedom from your urinary urges. Your health care provider may use one treatment alone or several at the same time. Treatment choices include:
- Limiting "bladder irritating" foods – Some people can reduce their symptoms by limiting "bladder irritating" food and drinks. Common irritants include coffee, tea, alcohol, soda, other fizzy drinks, citrus fruit and spicy foods. You can try taking all "bladder irritating" foods out of your diet and adding them back in one-by-one. Once you figure out which food and drink make your symptoms worse, you can avoid them.
- Bladder diary – Tracking your trips to the bathroom for a few days can help you and your health care provider understand your symptoms better. A diary may help point out any pattern to your symptoms. For example, are your symptoms worse after eating or drinking specific foods? Are they worse when you don't drink enough liquids? See our Bladder Diary and Instructions.
- Double voiding may be helpful for people who have trouble fully emptying their bladders. After urinating, you wait a few seconds and then try again to empty your bladder.
- Timed urination and bladder retraining – Your health care provider may ask you to do exercises to decrease urgency and help you hold more urine in your bladder. These exercises may include following a regular schedule to urinate. Instead of urinating when you feel the urge, you will be asked to go to the bathroom at set times each day.
- "Quick flick" exercises of your pelvic floor muscles can help you relax your bladder muscle when it contracts.
When lifestyle changes don't give enough relief, your health care provider may prescribe medicine to help manage your symptoms. Your provider may have you take the medicine alone or combine it together with lifestyle changes.
Medications used to treat OAB work by relaxing the bladder muscle to help stop it from contracting at the wrong times. These drugs can be given by mouth or through the skin using a gel or adhesive patch. Common side effects of taking these are dry mouth and eyes, constipation, and blurred vision. Your health care provider should follow you carefully to watch for changes in your symptoms and any side effects. To get the best results, your health care provider may need to try different doses or different medications.
Other Treatment Choices
If lifestyle changes and prescription drugs are not successful in managing your OAB symptoms, your health care provider may offer the following:
- Physical therapy: A physical therapist works with you on performing pelvic floor exercises, behavior modification and other techniques to improve bladder and pelvic floor muscle coordination.
- Bladder injections: In some severe cases of OAB, injecting Botox® into the bladder has been found to be effective in improving symptoms. Small amounts of Botox® can stop the bladder muscles from squeezing too much. Additional treatments are often given when this treatment wears off, anywhere from six to twelve months later. Your doctor will watch how you're doing to make sure you aren't retaining (holding in) too much urine. If urine is not draining well, you may need to catheterize temporarily.
- Nerve stimulation (Neuromodulation therapy): This type of treatment sends electrical pulses to nerves in your bladder. In OAB, the nerve signals between your bladder and brain don't work the right way. These electrical pulses interrupt the nerve signals, set them right, and improve OAB symptoms. This treatment may be prescribed when other treatment options have failed. There are two types of nerve stimulation:
- Sacral neuromodulation (SNS): This treatment changes how the sacral nerve works. The sacral nerve carries signals between the spinal cord and the bladder. Its job is to help hold and release urine. In OAB, these nerve signals aren't doing what they should. SNS uses a "bladder pacemaker" to control these signals to stop OAB symptoms. SNS is a two-step surgical process. The first step is to implant an electrical wire under the skin in your lower back. This wire is first connected to a handheld "pacemaker" to send pulses to the sacral nerve. You and your doctor will test whether or not this pacemaker can help you. If it helps, the second step is to implant a permanent pacemaker that can regulate the nerve rhythm.
- Percutaneous Tibial Nerve Stimulation (PTNS): This treatment is another way to correct the nerves in your bladder. For this type of nerve stimulation, surgery is not needed. PTNS is performed during an office visit that takes about 30 minutes. PTNS is done by placing a small electrode in your lower leg near your ankle. It sends pulses to the tibial nerve. The tibial nerve runs along your knee to the sacral nerves in your lower back. The pulses help control the signals that aren't working right. Often, patients receive 12 treatments, depending on how it's working.
OAB can get in the way of your work, social life, exercise and sleep. But you don't have to allow OAB symptoms to limit your life—there are treatments available to help. If you think you have OAB, please see your health care provider. You may be referred to a specialist in incontinence and OAB, such as a urologist. You can use our Find-A-Urologist tool to find a urologist in your area.