What is Overactive Bladder (OAB)?

Symptoms

What are the Symptoms of OAB?

Urgency: The major symptom of OAB is a sudden, strong urge to urinate that you can't ignore. This "gotta go" feeling makes you afraid you will leak urine if you don't get to a bathroom right away. You may or may not leak urine after feeling this urge to go.

If you live with OAB, you may also:

Leak urine (incontinence): Some­times people with OAB also have "urgency incontinence." This means that urine leaks after you feel the sudden urge to go.  Some people may leak just a few drops of urine.  Other people experience a sudden gushing of a large amount of urine.   

Urinate frequently: You may also need to go to the bathroom many times during the day. The number of times someone urinates differs from person to person. But many experts agree that going to the bathroom more than 8 times in 24 hours is "frequent urination."

Wake up at night to urinate: Having to wake from sleep to go to the bathroom more than once a night may be another symptom of OAB.

What Should You Do if You Think You Have OAB?

If you think you may have OAB, talk with your health care provider. Sometimes OAB symptoms can be the result of a urinary tract infection, an illness, damage to nerves, or a side effect of a medication. So it's important to go to a health care provider to find out if you have any of these problems. If you do have OAB, there are treatments to help. Together, you and your health care provider can choose what's best for you.

Causes

What Are the Causes of OAB?

How the Urinary Tract Works

Female Urinary Tract
Female urinary tract
Medical Illustration Copyright © 2015 Nucleus Medical Media, All rights reserved

Male Urinary Tract
Male urinary tract
Medical Illustration Copyright © 2015 Nucleus Medical Media, All rights reserved

The bladder and kidneys are part of the urinary system the organs in our bodies that produce, store and pass urine. You have 2 kidneys that produce urine. Then urine is stored in the bladder. The muscles in the lower part of your abdomen hold your bladder in place.

When it isn't full of urine, the bladder is relaxed. When nerve signals in your brain let you know that your bladder is getting full, you feel the need to urinate. If your urinary system is normal, you can delay urination for some time.

Once you are ready to urinate, the brain sends a signal to the bladder. Then the bladder muscles squeeze (or "contract"). This forces the urine out through the urethra, the tube that carries urine from your body. The urethra has muscles called sphincters. They help keep the urethra closed so urine doesn't leak before you're ready to go to the bathroom. These sphincters open up when the bladder contracts.

OAB can be caused by the nerve signals between your bladder and brain telling your bladder to empty even when it isn't full. OAB can also be the result of your bladder muscles being too active. Then your bladder muscles contract to pass urine before your bladder is full, and that causes a sudden, strong need to urinate. We call this "urgency."

Risk Factors for OAB

  • As you grow older, the risk of OAB symptoms increases. But not all people will have signs OAB as they age. No matter what your age, there are treatments that can help.
  • Overactive bladder and urine leakage are not “normal” or expected parts of the aging process.
  • Just because you are getting older doesn't mean your OAB symptoms can't respond to treatment
  • Both men and women are at risk for OAB. Women who have gone through menopause and men who have had prostate problems seem to be at greater risk for OAB.
  • People with diseases that affect the brain or spinal cord, such as stroke and multiple sclerosis, are at high risk for OAB.

Diagnosis

How is OAB Diagnosed?

After you talk about your symptoms, your health care provider may do an exam right away. He or she may also schedule a separate exam to see if you have OAB. Your health care provider may refer you to a specialist, such as a urologist, who can perform the exam. Some urologists specialize in incontinence and OAB.

Medical History

Your health care provider will ask you a number of questions to understand your medical history. This should include information about the symptoms you are having, how long you have had them, and how they are changing your life. A medical history will also include information about your past and current health problems. You should bring a list of over-the-counter and prescription drugs you take. Your health care provider should also ask you about your diet, and about how much and what kinds of liquids you drink during the day.

Physical Exam

Your health care provider will examine you to look for something that may be causing your symptoms. In women, the physical exam will likely include your abdomen, the organs in your pelvis, and your rectum. In men, a physical exam will include your abdomen, prostate, and rectum.   

Bladder Diary

You may be asked to keep a bladder diary, where you will note how often you go to the bathroom and any time you leak urine. This will help your health care provider learn more about your day-to-day symptoms.   

Other Tests

  • Urine culture: Your health care provider may ask you to leave a sample of your urine to test for infection or blood.
  • Bladder scan: This type of ultrasound shows how much urine is still in the bladder after you go to the bathroom.
  • Cystoscopy:  During this test, the doctor inserts a narrow tube with a tiny lens into the bladder. This can be used to rule out other causes of your symptoms.
  • Urodynamic testing: These tests check to see how well your lower urinary tract stores and releases urine.
  • Symptom Questionnaire: Many doctors use a written quiz to ask questions about your bladder problems and what causes you the most bother. 

Treatment

What Treatments are Available for OAB?

There are a number of treatments to help manage OAB. Your health care provider may prescribe treatment to help you manage your symptoms, or you may be referred to a specialist, such as a urologist, for treatment.

Treatment choices for OAB include:

No single treatment is right for everyone. Your health care provider may use 1 treatment alone, or several at the same time. You and your health care provider should talk about what you want from treatment and about each treatment choice.

More Information

More Information

General Questions to Ask Your Health Care Provider

  • Can you prevent OAB?
  • Can you cure OAB?

Questions About Diagnosis

  • Can you help me or do I need to see a specialist?
  • If I need a specialist, how can I find the right one for me?
  • Will I need to have tests to find out if I have OAB?
  • Would you explain each test, and why you think I need them?
  • Are there any dangers of hav­ing these tests?
  • If I don't have OAB, what other problem could be causing my symptoms, and why?

Questions About Treatment

  • What types of treatment are there for OAB?
  • Are there problems that can come from treatment?
  • What are the pros and cons of each type of treatment?
  • What treatment do you think is right for me and why?
  • How soon after treatment will I feel better?
  • After I start treatment, are there problems I should I watch out for?
  • When should I call you?
  • What happens if the first treatment doesn't help?
  • Will I need treatment for the rest of my life?
  • Are there any exercises I can do to help my symptoms?
  • Do I need to see a physical therapist?
  • Are there any lifestyle changes I can make that could help my symptoms?
  • What would happen if I didn't treat OAB?
  • What's my next step?