What is an Overactive Bladder

Overactive bladder refers to a condition in which a person has a sudden need to pass urine. The person may leak urine if he or she cannot get to the bathroom fast enough (urinary incontinence).

A person with this condition may also wake up several times in the night to go to the bathroom.

Overactive bladder is associated with poor nerve signals between your bladder and your brain. Your bladder may get the signal to empty before it is full. You may also have very sensitive muscles that make your bladder squeeze too soon. These symptoms might interfere with daily work or social activities.

What are the causes?

This condition may be associated with or caused by:

• Urinary tract infection.
• Infection of nearby tissues, such as the prostate.
• Prostate enlargement.
• Surgery on the uterus or urethra.
• Bladder stones, inflammation, or tumors.
• Drinking too much caffeine or alcohol.
• Certain medicines, especially medicines that get rid of extra fluid in the body (diuretics).
• Muscle or nerve weakness, especially from:
  • A spinal cord injury.
  • Stroke.
  • Multiple sclerosis.
  • Parkinson’s disease.
• Diabetes.
• Constipation.

What increases the risk?

You may be at greater risk for overactive bladder if you:

• Are an older adult.
• Smoke.
• Are going through menopause.
• Have prostate problems.
• Have a neurological disease, such as stroke, dementia, Parkinson’s disease, or multiple sclerosis (MS).
• Eat or drink things that irritate the bladder. These include alcohol, spicy food, and caffeine.
• Are overweight or obese.

What are the signs or symptoms?

Symptoms of this condition include:

• Sudden, strong urge to urinate.
• Leaking urine.
• Urinating 8 or more times a day.
• Waking up to urinate 2 or more times a night.

How is this diagnosed?

Your health care provider may suspect overactive bladder based on your symptoms. He or she will diagnose this condition by:

• A physical exam and medical history.
• Blood or urine tests. You might need bladder or urine tests to help determine what is causing your overactive bladder.

You might also need to see a health care provider who specializes in urinary tract problems (urologist).

How is this treated?

Treatment for overactive bladder depends on the cause of your condition and whether it is mild or severe. You can also make lifestyle changes at home. Options include:

• Bladder training. This may include:
  • Learning to control the urge to urinate by following a schedule that directs you to urinate at regular intervals (timed voiding).
  • Doing Kegel exercises to strengthen your pelvic floor muscles, which support your bladder. Toning these muscles can help you control urination, even if your bladder muscles are overactive.
• Special devices. This may include:
  • Biofeedback, which uses sensors to help you become aware of your body’s signals.
  • Electrical stimulation, which uses electrodes placed inside the body (implanted) or outside the body. These electrodes send gentle pulses of electricity to strengthen the nerves or muscles that control the bladder.
  • Women may use a plastic device that fits into the vagina and supports the bladder (pessary).
• Medicines.
  • Antibiotics to treat bladder infection.
  • Antispasmodics to stop the bladder from releasing urine at the wrong time.
  • Tricyclic antidepressants to relax bladder muscles.
  • Injections of botulinum toxin type A directly into the bladder tissue to relax bladder muscles.
• Lifestyle changes. This may include:
  • Weight loss. Talk to your health care provider about weight loss methods that would work best for you.
  • Diet changes. This may include reducing how much alcohol and caffeine you consume, or drinking fluids at different times of the day.
  • Not smoking. Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Surgery.
  • A device may be implanted to help manage the nerve signals that control urination.
  • An electrode may be implanted to stimulate electrical signals in the bladder.
  • A procedure may be done to change the shape of the bladder. This is done only in very severe cases.

Follow these instructions at home:

Lifestyle

• Make any diet or lifestyle changes that are recommended by your health care provider. These may include:
  • Drinking less fluid or drinking fluids at different times of the day.
  • Cutting down on caffeine or alcohol.
  • Doing Kegel exercises.
  • Losing weight if needed.
  • Eating a healthy and balanced diet to prevent constipation. This may include:
    • Eating foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limiting foods that are high in fat and processed sugars, such as fried and sweet foods.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Use any implants or pessary as told by your health care provider.
• If needed, wear pads to absorb urine leakage.
• Keep a journal or log to track how much and when you drink and when you feel the need to urinate. This will help your health care provider monitor your condition.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• Your symptoms do not get better with treatment.
• Your pain and discomfort get worse.
• You have more frequent urges to urinate.

Get help right away if:

• You are not able to control your bladder.

Summary

• Overactive bladder refers to a condition in which a person has a sudden need to pass urine.
• Several conditions may lead to an overactive bladder.
• Treatment for overactive bladder depends on the cause and severity of your condition.
• Follow your health care provider’s instructions about lifestyle changes, doing Kegel exercises, keeping a journal, and taking medicines.