Overactive bladder is a collection of symptoms that may affect how often you pee and your urgency. Causes include abdominal trauma, infection, nerve damage, medications and certain fluids. Treatment includes changing certain behaviors, medications and nerve stimulation.
Overactive bladder (OAB) is a combination of symptoms that may cause you to urinate (pee) more frequently, have uncontrollable urges to pee, experience incontinence and have to pee at night.
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Overactive bladder is most common in people 65 and older. Women may have OAB at a younger age, usually around 45.
Overactive bladder is common. It affects up to 33 million adults in the U.S., including as many as 30% of men and 40% of women. However, that number may be higher because many people may feel embarrassed and won’t get help.
Overactive bladder symptoms can cause stress and affect your quality of life.
No, overactive bladder doesn’t go away on its own. If you don’t treat OAB, your symptoms can get worse, the muscles in your bladder that help control when you pee can become weak and your pelvic floor tissues can get thinner.
Overactive bladder represents a collection of symptoms. These symptoms include:
Conditions or injuries that affect your detrusor muscle cause overactive bladder. Your detrusor muscle is a collection of smooth muscle fibers in the wall of your bladder. These conditions may include:
A healthcare provider can diagnose overactive bladder by reviewing your symptoms and conducting a physical examination of the organs around your pelvis and rectum. They may ask you questions such as:
They may also refer you to a urologist. A urologist is a doctor who specializes in diseases and conditions that affect your urinary tract and reproductive system.
A healthcare provider may order tests to help diagnose overactive bladder. These tests may include:
Different treatments can help fix your overactive bladder. Treatments may include changing certain behaviors, medications and nerve stimulation (neuromodulation).
You can make many changes to your behavior to help fix your overactive bladder. These include:
A healthcare provider may ask you to keep a bladder diary for a few days. Noting what happened before you had an accident can help the provider determine the cause of your OAB. You’ll use your bladder diary to track:
Stop eating or cut back on drinks or foods that may cause bladder symptoms. These may include:
Constipation can place pressure on your bladder and affect your bladder function. You may be able to avoid constipation and reduce bladder symptoms by keeping healthy bowel habits. The following can help you maintain bowel regularity:
Having overweight can put pressure on your bladder, which may contribute to bladder control problems. Maintaining a weight that’s healthy for you can reduce pressure on your bladder.
Cigarettes and other tobacco products can irritate your bladder muscle. Coughing spasms due to smoker’s cough can also cause leakage.
When you have OAB, your body conditions your bladder muscles to react a certain way. By resetting your bladder muscles, you may hold your pee better.
Bladder retraining teaches you how:
The following steps can help you reset your overactive bladder:
Managing your urges is a key step in resetting your bladder. The following strategies may help:
Patience is important. Retraining your bladder usually takes at least six to eight weeks to see results. Talk to a healthcare provider if you have any questions or aren’t happy with your progress. They may prescribe medications for you to take while you’re resetting your bladder to help you achieve the best outcome.
Yes, nerve stimulation can help improve OAB. Your nerves help tell your brain that your bladder is full. By treating your nerves, you can improve your bladder control.
Nerve stimulation is a reversible treatment. Healthcare providers only recommend it if other treatments don’t work.
There are several types of nerve stimulation treatments. These include:
Sacral nerve stimulation is a therapy that electrically stimulates the nerves that control your bladder.
A healthcare provider will implant a small device called a neurotransmitter under the skin near your upper buttock (butt) area. The neurotransmitter sends mild electrical impulses through a wire near your sacral nerve. Your sacral nerve is a nerve in your lower back. The impulses help you control your bladder.
Sacral nerve stimulation can reduce the number of times you have to use the bathroom or the number of times you accidentally leak pee. It’s overall very effective. It’s also an outpatient procedure, so you can go home afterward.
Percutaneous tibial stimulation sends small nerve impulses to a nerve branch near your ankle. It helps stimulate bladder control.
Percutaneous tibial nerve stimulation is an outpatient procedure. Many people need 12 weekly sessions and then monthly maintenance sessions afterward.
Botox® is the most well-known botulinum toxin brand. A healthcare provider injects Botox into your bladder wall using a cystoscope.
This therapy is very effective, even for patients who haven’t responded well to other therapies. A small number of people may have temporary urinary retention (difficulty peeing) after a Botox injection.
Botox injections wear off over time. Most people need to repeat injections every six months.
As you’re retraining your bladder, a healthcare provider may prescribe medication. Medications can help restore normal bladder function. Commonly prescribed medications for overactive bladder include:
Anticholinergic medications help regulate muscle spasms in your bladder. A healthcare provider may prescribe:
Beta-3 adrenergic medications cause the detrusor muscles in your bladder to relax so your bladder can store more pee. A healthcare provider may prescribe:
Pelvic floor exercises and changes to your lifestyle may take six to eight weeks before you start to see results.
Many medications start to relax your bladder muscles after a few hours. But they may take up to a month to work fully.
Botox should start to work after one to two weeks.
Most people start to see improvement after six nerve stimulation treatments. However, it may take up to 12 treatments to see results.
Lifestyle adjustments can help reduce your risk of developing an overactive bladder. These may include:
Overactive bladder symptoms can cause considerable stress. Treatment can be challenging to manage, and symptoms may never completely disappear. But many people are satisfied with the treatment they receive and often experience a dramatic improvement in their quality of life.
If treatments don’t work for you, or if you’re waiting for them to take effect, incontinence products such as disposable pads or adult diapers can help you feel in control and improve your quality of life.
The following can help boost your comfort and confidence if you’re wearing incontinence products:
See a healthcare provider if you experience any symptoms of an overactive bladder.
Age-related OAB may develop gradually and slowly worsen over time. If your symptoms develop suddenly and you have heavy leakage, your OAB may be a symptom of another condition, such as an infection or a neurological issue. It’s best to have a provider check these symptoms sooner rather than later.
A note from Cleveland Clinic
Overactive bladder is a common condition that causes changes in your bathroom habits, which can be embarrassing. Many people struggle to talk to a healthcare provider about their symptoms. However, providers can help answer any of your questions without judgment. They can determine the cause of your overactive bladder and work with you to develop the best treatment plan. If you have symptoms of overactive bladder, talk to a healthcare provider so you can better manage your bathroom habits and improve your quality of life.
Last reviewed by a Cleveland Clinic medical professional on 09/13/2022.
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