Overactive bladder is a group of urinary symptoms. With overactive bladder, you may suddenly feel the need to pass urine (urinate) right away. After feeling this sudden urge, you might also leak urine if you cannot get to the bathroom fast enough (urinary incontinence). These symptoms might interfere with your daily work or social activities. Overactive bladder symptoms may also wake you up at night.
Overactive bladder affects the nerve signals between your bladder and your brain. Your bladder may get the signal to empty before it is full. Very sensitive muscles can also make your bladder squeeze too soon.
- Urinary tract infection.
- Infection of nearby tissues, such as the prostate.
- Prostate enlargement.
- Being pregnant with twins or more (multiples).
- Surgery on the uterus or urethra.
- Bladder stones, inflammation, or tumors.
- Drinking too much caffeine or alcohol.
- Certain medicines, especially those that you take to help your body get rid of extra fluid (diuretics) by increasing urine production.
- Muscle or nerve weakness, especially from:
- A spinal cord injury.
- Multiple sclerosis.
- Parkinson disease.
- Diabetes. This can cause a high urine volume that fills the bladder so quickly that the normal urge to urinate is triggered very strongly.
- Constipation. A buildup of too much stool can put pressure on your bladder.
- Older adults.
- Prostate problems.
- A neurological disease, such as stroke, dementia, Parkinson disease, or multiple sclerosis (MS).
- Eating or drinking things that irritate the bladder. These include alcohol, spicy food, and caffeine.
- Overweight or obese.
- Sudden, strong urges to urinate.
- Leaking urine.
- Urinating eight or more times per day.
- Waking up to urinate two or more times per night.
- Your symptoms.
- A physical exam and take your medical history.
- Blood or urine tests.
- A bladder function test to check how well you can hold your urine.
- You might also need to see a health care provider who specializes in the urinary tract (urologist).
Depending on the cause of your condition and whether it is mild or severe, treatment may include:
- Biofeedback. A specialist uses sensors to help you become aware of your body’s signals.
- Keeping a daily log of when you need to urinate and what happens after the urge. This may help you manage your condition.
- Bladder training. This helps you learn to control the urge to urinate by following a schedule that directs you to urinate at regular intervals (timed voiding). At first, you might have to wait a few minutes after feeling the urge. In time, you should be able to schedule bathroom visits an hour or more apart.
- Kegel exercises. These are exercises to strengthen the pelvic floor muscles, which support the bladder. Toning these muscles can help you control urination, even if your bladder muscles are overactive. A specialist will teach you how to do these exercises correctly. They require daily practice.
- Weight loss. If you are obese or overweight, losing weight might relieve your symptoms of overactive bladder. Talk to your health care provider about losing weight and whether there is a specific program or method that would work best for you.
- Diet change. This might help if constipation is making your overactive bladder worse. Your health care provider or a dietitian can explain ways to change what you eat to ease constipation. You might also need to consume less alcohol and caffeine or drink other fluids at different times of the day.
- Stopping smoking.
- Wearing pads to absorb leakage while you wait for other treatments to take effect.
- Electrical stimulation. Electrodes send gentle pulses of electricity to strengthen the nerves or muscles that help to control the bladder. Sometimes, the electrodes are placed outside of the body. In other cases, they might be placed inside the body (implanted). This treatment can take several months to have an effect.
- Supportive devices. Women may need a plastic device that fits into the vagina and supports the bladder (pessary).
- Several medicines can help treat overactive bladder and are usually used along with other treatments. Some are injected into the muscles involved in urination. Others come in pill form. Your health care provider may prescribe:
- Antispasmodics. These medicines block the signals that the nerves send to the bladder. This keeps the bladder from releasing urine at the wrong time.
- Tricyclic antidepressants. These types of antidepressants also relax bladder muscles.
- You may have a device implanted to help manage the nerve signals that indicate when you need to urinate.
- You may have surgery to implant electrodes for electrical stimulation.
- Sometimes, very severe cases of overactive bladder require surgery to change the shape of the bladder.
Follow these instructions at home:
- Take medicines only as directed by your health care provider.
- Use any implants or a pessary as directed by your health care provider.
- Make any diet or lifestyle changes that are recommended by your health care provider. These might include:
- Drinking less fluid or drinking at different times of the day. If you need to urinate often during the night, you may need to stop drinking fluids early in the evening.
- Cutting down on caffeine or alcohol. Both can make an overactive bladder worse. Caffeine is found in coffee, tea, and sodas.
- Doing Kegel exercises to strengthen muscles.
- Losing weight if you need to.
- Eating a healthy and balanced diet to prevent constipation.
- Keep a journal or log to track how much and when you drink and also when you feel the need to urinate. This will help your health care provider to monitor your condition.
Contact a health care provider if:
- Your symptoms do not get better after treatment.
- Your pain and discomfort are getting worse.
- You have more frequent urges to urinate.
- You have a fever.
Seek immediate treatment if:
- You are not able to control your bladder at all.
This information is not intended to replace advice given to you by your health care provider.