Published: April 11, 2024

8 Treatment Options for Overactive Bladder: Find Which Is Right for You

By: Katie M. Rosen, D.O.

If the sound of running water gives you an urgent need to pee, then you probably have a hunch about what it’s like to experience the symptoms of overactive bladder (OAB). Lots of people do.

OAB, the sudden and hard-to-control urge to urinate, affects nearly 33 million people in the U.S. alone. That breaks down to an estimated 40% of women and 30% of men.

But many of these OAB sufferers live with it instead of talking to a doctor because they’re embarrassed, don’t know how to bring up the topic, and don’t realize treatments are available.

Here’s what you should know: You can take control!

What Happens in Your Body That Causes OAB

First off, OAB is not a disease. It’s the medical term for a group of urinary symptoms that occur due to illness or changes in your body. These conditions include:

  • A bladder obstruction such as stones, urethral scarring, or an enlarged prostate in men
  • Menopause-related hormone changes that weaken pelvic tissue in women
  • Diabetes
  • Kidney disease
  • Nerve damage or misfires by the sacral nerve, which controls bladder muscles
  • Neurological disorders, including Parkinson’s disease, multiple sclerosis, or stroke

The most common symptoms of OAB, in addition to the urgent need to pee, include leakage, having to pee sooner than every two hours, and waking up more than twice a night to urinate (nocturia).

Untreated, the symptoms of OAB can worsen, causing your bladder muscles and pelvic floor to weaken. This can be prevented.

OAB Is Not A Choice, But You Have Options

If you’ve been experiencing the above symptoms, your doctor can perform several tests to determine if OAB is behind them, including a physical exam and urine test (urinalysis). Other diagnostics might include:

Post-void residual – This test gauges how much your bladder empties when going to the bathroom.

Urine flow test  This is a process in which you pee into a funnel so the doctor can evaluate the force of your stream.

Cystoscopy – The doctor feeds a slender, camera-equipped scope into the urethra to identify potential abnormalities.

Urodynamics – Here, scopes are inserted into the urethra and rectum to measure bladder pressure when you pee.

Based on your diagnosis, your doctor will likely suggest the least-invasive therapies first.

Behavioral and Training Approaches

  • Lifestyle modifications –This could include reducing caffeine, alcohol, and artificial sweeteners, losing weight, and avoiding liquids two to three hours before sleep.
  • Kegel exercises – Strengthening your pelvic floor muscles by tightening and releasing them at regular intervals.
  • Bladder training – Train yourself to hold off on going to the bathroom, starting with short waits and gradually extending them.

Medications, Nerve Stimulation, and Surgical Options

  • Oral medications – Several muscle-relaxing drugs can prevent the bladder from contracting involuntarily.
  • Botox – Sometimes advised for patients who do not respond to oral medications, Botox injections have proven effective in relaxing the bladder.
  • InterStim Therapy – The doctor implants a small device near your bottom that delivers pulses to the nerves controlling your bladder. You’d likely undergo a trial period first.
  • Tibial nerve stimulation – This is a multi-visit therapy in which electrical pulses are sent to a bladder-affecting nerve near your ankle. Treatment typically takes 12 weekly sessions.
  • Tension-free vaginal tape (for women) –In this surgical approach, mesh tape is inserted under the urethra to hold it in its natural position.

Treating OAB Today Means Sleeping Better Tomorrow

OAB treatment begins with preparation. Keep a bladder diary to bring to your first appointment so you can accurately describe your symptoms, how often they occur, and the activities that cause leakage.

Then, keep updating the diary. Your entries will likely include fewer “incidents” and longer visits to the lake.

You don’t have to endure the symptoms of OAB alone. Our doctors talk to patients about their condition every day. Learn more about what you can expect during OAB treatment here.

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