An overactive bladder, also called OAB, causes the urge to urinate frequently and suddenly, which can be difficult to control. You may feel like you have to urinate several times during the day and night, and you may experience accidental urine leakage (urge urinary incontinence).

An overactive bladder can embarrass you, isolate you, or limit your work and social life. The good news is that a quick assessment can determine if there is a specific cause for your overactive bladder symptoms.

You may be able to manage the symptoms of an overactive bladder with simple behavioral strategies such as diet changes, timed evacuations, and techniques that use the pelvic floor muscles to support the bladder. If these initial efforts don’t help enough to relieve your symptoms of overactive bladder, additional treatments are available.

If you have an overactive bladder, you can:

Have a sudden urge to urinate that is difficult to control
Accidental leakage of urine immediately after an urgent need to urinate (urge incontinence)
Urinate frequently, usually eight or more times in a 24-hour period
Waking up more than twice a night to urinate (nocturia)

When to see a doctor
While not uncommon in older people, an overactive bladder is not a normal part of aging. Discussing your symptoms may not be easy, but if they are a burden or disrupt your life, talk to your doctor. There are treatments available that might help.

Normal bladder function
Female urinary system anatomy
Female Urinary System Open Popup Dialog Male Urinary System Anatomy
Male Urinary System Open Context Dialog
The kidneys produce urine that flows into your bladder. When you urinate, urine from your bladder flows through a tube called the urethra (u-REE-thruh). A muscle in the urethra called the sphincter opens to release urine from the body.

In women, the urethral opening is just above the vaginal opening. In men, the urethral opening is located at the end of the penis.

As your bladder fills, nerve signals sent to your brain eventually trigger the need to urinate. During urination, these nerve signals coordinate the relaxation of the muscles of the pelvic floor and the muscles of the urethra (urinary sphincters). The muscles of the bladder contract (contract), expelling urine.

Involuntary bladder contractions
An overactive bladder occurs because the muscles in the bladder involuntarily contract, even when the volume of urine in your bladder is small. These involuntary contractions cause an urgent need to urinate.

Several conditions can contribute to the signs and symptoms of an overactive bladder, including:

Neurological disorders such as stroke and multiple sclerosis
Urinary tract infections, which can cause symptoms similar to an overactive bladder
Hormonal changes during menopause in women
Bladder abnormalities, such as tumors or bladder stones
Factors that prevent bladder flow – enlarged prostate, constipation, or previous surgeries to treat other forms of incontinence
Other factors that may be related to your symptoms include:

Medicines that cause your urine output to rise rapidly or that require you to take them with plenty of fluids
Excessive consumption of caffeine or alcohol
Decreased cognitive function due to aging, which can make it more difficult for your bladder to understand the signals it receives from your brain
Difficulty walking which can make the bladder rush if you cannot get to the toilet quickly
Incomplete emptying of the bladder, which can lead to symptoms of an overactive bladder due to limited urine storage space
The specific cause of an overactive bladder may not be known.

Risk factors
As you age, the risk of developing an overactive bladder increases. You are also at higher risk of developing diseases and disorders such as an enlarged prostate and diabetes, which can contribute to other bladder problems.

Many people with cognitive decline – such as those who have had a stroke or have Alzheimer’s disease – develop an overactive bladder. Incontinence resulting from such situations can be managed with fluid schedules, timed and immediate empties, absorbent clothing, and bowel programs.

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