Overactive Bladder

Overactive bladder (OAB) syndrome is a condition that causes a sudden urge to pee during the day or at night, or a need to urinate more frequently. It can result in accidental urine leakage, called incontinence.

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On this page 

• What Is Overactive Bladder? 
• What Are the Symptoms of Overactive Bladder?
• How Do You Diagnose Overactive Bladder?
• How Do You Treat Overactive Bladder? 

What Is Overactive Bladder? 

Overactive bladder (OAB) is a term for a larger set of urinary-related symptoms rather than one distinct disease.

Doctors define overactive bladder as a sudden urge to urinate several times throughout the day and night. This urgency can lead to urinary leakage (incontinence). While this condition isn't serious, it can lead to moments of inconvenience, embarrassment, and even urinary tract infections (UTIs).

OAB syndrome becomes more common as you age. Symptoms often become more severe the older you get, too.

Although symptoms of OAB can often be managed, many people suffer in silence. Even if you're embarrassed about your condition, it's important to share your symptoms with your doctor.

How common is overactive bladder?

Overactive bladder is a common chronic medical condition. The National Overactive Bladder Evaluation Programs’ research showed that some 33 million Americans might be living with overactive bladder issues.

The National Institutes of Health (NIH) estimates that up to 16.5% of Americans have OAB symptoms affecting their daily activities.

What causes overactive bladder?

In many cases, doctors don't know what causes OAB.

But overactive bladder can be a result of:

• Spinal cord injury.
• Pelvic surgery.
• Bladder issues.
• Medicines you take.

Talk with your doctor about whether your medication regimen could be affecting your bladder. But don't stop taking any medications without consulting your doctor first.

What are overactive bladder risk factors and complications? 

Overactive bladder risk factors

You may be at risk of OAB because of:

• Faulty nerve signals between your brain and bladder.
• Hormonal changes.
• Weakness or spasms in your pelvic muscles.
• UTI.
• Medication side effects.
• Health conditions that affect the brain or spinal cord, such as stroke and multiple sclerosis.

Complications of overactive bladder

Left untreated, OAB can affect you physically and emotionally. It may get in the way of work, social life, exercise, and sleep.

Fear of being far from a bathroom or leaking pee can make you reluctant to go far from home. This social isolation can affect relationships with friends and family, bringing about feelings of loneliness and depression.

In addition, getting up multiple times a night can disrupt your sleep and sex life. Too little sleep can also contribute to depression.

Physically, if you leak urine, you may develop skin problems or infections.

How can I reduce my risks of overactive bladder? 

Many things can cause overactive bladder, and some treatments can also prevent it.

To lower your risk of an overactive bladder, you can:

• Train your bladder. Bladder training helps you slowly increase how long you can wait before you have to pee.
• Cut back on caffeine, carbonated drinks, and alcohol.
• Practice double voiding. This is when you use the bathroom and wait a few seconds before trying to go again.
• Maintain a healthy weight.
• Do pelvic floor exercises (Kegels) to strengthen some of the muscles that control the flow of urine. It may help to work with a physical therapist with special training in pelvic muscle exercises.
• Prevent constipation by eating a healthy, high-fiber diet.
• Practice timed urination. This is when you set a schedule to use the restroom instead of going whenever you feel an urge. This method may mean going even when you don’t feel you have to, so you can prevent that urgent feeling and remain in control of your bladder.

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What Are the Signs and Symptoms of Overactive Bladder?

The main symptoms of overactive bladder are:

• An urgent need to pee.
• Leaking urine when you have the urge to pee.
• Taking many trips to the toilet only to urinate just a little bit each time.
• Having a need to urinate even if you've just gone.
• The need to urinate often.
• Waking up to pee two or more times a night.

If you have overactive bladder, you may have some or all of these symptoms.

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How Do You Diagnose Overactive Bladder? 

Your primary care provider can diagnose overactive bladder but they may refer you to a urologist, gynecologist, or urogynecologist for more specialized care.

Your doctor will ask you about your health history, the symptoms you're having, and prescribed and over-the-counter (OTC) medications and supplements you take.

They may also perform a physical exam. Depending on your symptoms, you might need a pelvic exam. If your symptoms could be caused by colorectal problems, you might also need a rectal exam.

Before your visit, it can helpful to track:

• What kinds of fluids you drink.
• How much you drink during the day.
• How often you urinate.
• If you leak.

Your doctor might take a sample of your urine. Depending on the results, or if your doctor thinks that your problem may have more than one cause, you may have more tests. For example, an ultrasound will show how much urine is left in your bladder after using the bathroom.

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How Do You Treat Overactive Bladder? 

The first step in treating your overactive bladder might be simply planning your routine around your condition. For example, you can take the appropriate preventive steps and also not drink fluids before bed. You might clear a path from your bed to the bathroom or place a portable toilet in your bedroom.

While these measures won't cure OAB, they can make it easier to live with this condition.

Medicines for OAB

There are medications that can help treat OAB. This includes topical estrogen if atrophy (thinning of vaginal tissue) is a problem.

If your symptoms really bother you or affect your quality of life, your doctor might suggest that you try certain medicines along with bladder training exercises.

These medicines include:

• Drugs that calm the bladder muscles, such as darifenacin, fesoterodine, and oxybutynin. They may cause side effects like dry mouth and constipation.
• Drugs that help the bladder store more urine, such as mirabegron and vibegron. Side effects may include increased blood pressure, headaches, and a runny nose.

Surgery for overactive bladder

Some cases of overactive bladder syndrome may require surgery.

These surgeries aim to correct an issue, such as:

• Augmentation cystoplasty — Makes the bladder bigger.
• Urinary diversion — Creates another way to store and pass urine.

Other OAB treatments

For severe overactive bladder or severe urge incontinence that hasn’t been controlled by exercises or medicine, there are other treatments.

Botulinum toxin (Botox^®) injections

You may need to get Botox bladder injections every three to 12 months. Side effects may include having pain when you pee, not being able to urinate easily, and getting a urinary tract infection (UTI).

Electrical stimulations

• Percutaneous tibial nerve stimulation (PTNS) — Mild electrical stimulation is given through a needle placed behind the ankle. Regularly scheduled sessions help reduce symptoms.
• Sacral nerve stimulation (SNS) — An electrical stimulator placed under your skin sends pulses to the sacral nerve in your lower back. This nerve plays a role in bladder storage and emptying.

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By UPMC Editorial Staff. Last reviewed on 2024-09-05.