Overcoming an Overactive Bladder

Content provided by the Faculty of Harvard Medical School
This content is selected and managed by the Healthgrades editorial staff and is brought to you by an advertising sponsor.
x

This content is created or selected by the Healthgrades editorial team and is funded by an advertising sponsor. The content is subject to the Healthgrades medical review process for accuracy, balance and objectivity. The content is not edited or otherwise influenced by the advertisers appearing on this page except with the possible suggestion of the broad topic area. For more information, read the HealthGrades advertising policy.

ADVERTISEMENT

How Often Should You "Go"?

Most adults urinate four to seven times per day. If your daily routine is far in excess of that, talk with your doctor. 

Get your life back if you're experiencing this easily treatable condition.

An overactive bladder (OAB, also known as urge incontinence) causes a sudden urge to urinate, even when your bladder isn't full. For some people it's simply a nuisance. For others, the urge can't be controlled, which leads not only to incontinence but also a severe impact on quality of life. "It's a major problem which limits people's social lives due to fear of embarrassing urine leakage. It is a significant contributory factor to depression. I have some patients who rarely venture outside of home because they are afraid they will wet themselves while in a public place," says Dr. George Flesh, director of urogynecology and pelvic reconstructive surgery for Harvard Vanguard Medical Associates.

Why it happens

When the kidneys filter toxins and extra liquid from the blood, the waste (urine) is stored in the bladder. Your nerves signal the kidneys to fill the bladder, and also signal the brain when the bladder is full and needs to be emptied. When the bladder empties, the muscle in the bladder wall contracts, and the sphincter muscle that controls urine flow relaxes.

Sometimes the nerves malfunction, causing the bladder to contract unpredictably. The result is a sudden need to urinate, known as dry OAB. When the feeling is uncontrollable, urine leaks out before a person can get to a bathroom. This is called wet OAB. Symptoms of these include frequency (eight or more times per day, and several times per night), a feeling of urgency, urine leakage, and waking from sleep to urinate.

OAB is different from stress incontinence, which happens when an increase in pressure in the abdomen—when you cough, for example—pushes down on the bladder and urethra and causes leakage.

Causes and diagnosis

OAB can be caused by something temporary, such as a bladder infection. It can also result from another condition, such as multiple sclerosis, Parkinson's disease, stroke, or diabetes. Women are twice as likely as men to struggle with OAB, because of the stress of childbirth on the urinary tract, for instance, as well as the loss of estrogen after menopause. In men, OAB may occur as the result of an enlarged prostate. "As the prostate enlarges it obstructs flow, and this results in increased bladder muscle activity," explains urologist Dr. Michael O'Leary, a professor of surgery at Harvard Medical School.

Many people don't report OAB symptoms to their doctor. "They are embarrassed to talk about it, they think it is a normal problem of aging, they think the doctor is too busy to deal with another problem added to their list, or they are unaware that treatment is available," says Dr. Flesh.

Diagnosis involves a history and physical exam and possibly tests that measure how much urine your bladder can store, how much urine you are able to release, the force of your urine flow, and how much urine is still in your bladder after you've tried to empty it.

Kegel exercises strengthen the muscles that support the bladder. To perform a Kegel, squeeze the muscles you would use to start and stop urination, or hold in a bowel movement. Hold the contraction for five seconds, then release. Try to do three sets of 10 Kegel exercises a day.

kegel exercise

What you can do

If you're a woman and your doctor determines that you have OAB, the first line of defense will likely be Kegel exercises, which involve squeezing and releasing the muscles you use to hold in urine. Vaginal estrogen creams may also relieve OAB symptoms for postmenopausal women, since estrogen helps to decrease the sensation of urgency and the chance of involuntary bladder contraction.

For men, the first line of defense is medication. Typical regimens, according to Dr. O'Leary, include alpha blockers—such as terazosin (Hytrin) and doxazosin (Cardura)—to relax the muscles in the prostate and relieve the blockage, in combination with anticholinergics—such as oxybutynin (Ditropan) and tolterodine (Detrol)—to relax the bladder muscle. Anticholinergic side effects include dry mouth and constipation.

Last Review Date: Oct 1, 2013

© 2015 Harvard University. All rights reserved. Content Licensing by Belvoir Media Group.

We'd like your feedback.

Thank you for visiting the Simple Solutions for an Overactive Bladder Health Center! You have been randomly selected to participate in a customer satisfaction survey to let us know how we can improve your website experience.

The survey is designed to measure your entire experience and will appear at the end of your visit.

Thank you!

A survey will be presented to you after you finish viewing our Simple Solutions for an Overactive Bladder content.

You Might Also Like

E-mail this page to your friends.

© Copyright 2015 Healthgrades Operating Company, Inc. Patent US Nos. 7,752,060 and 8,719,052. All Rights Reserved. 
Third Party materials included herein protected under copyright law.

Use of this website and any information contained herein is governed by the Healthgrades User Agreement.

PREVIOUS ARTICLE:

How Aging Affects Your Bladder

NEXT ARTICLE:

7 Hints for Better Bladder Control

Up Next

7 Hints for Better Bladder Control