Overactive bladder, also called urge incontinence, is the sudden, overwhelming urge to urinate several times during the day and night. Urge incontinence is also called hyperactive or irritable bladder. It occurs when nerve passages along the pathway from the bladder to the brain give the wrong signal to the brain or the brain is unable to inhibit the bladder muscle from contracting. Urinary incontinence is the loss of urine control, or the inability to hold your urine until you can reach a restroom. According to the National Association for Continence, approximately 25 million adult Americans experience temporary or chronic urinary incontinence. In addition to urge incontinence, there are three other basic types of urinary incontinence: stress incontinence, overflow incontinence, and functional incontinence. Although urinary incontinence is possible at any age, it often starts between the ages of 30 and 50. Women older than age 50 are the most likely to develop it. Urinary incontinence may be a temporary condition, resulting from an underlying medical condition. It can range from the discomfort of slight losses of urine to severe, frequent wetting. A large percentage of those with urinary incontinence severely limit their interaction with other people to avoid embarrassment, and most do not even disclose their problem to their doctor. Bladder control is a complex process that involves the brain, spinal cord, and muscles of the bladder and pelvis. For example, during routine urination certain muscles contract while others simultaneously relax. Loss of bladder control can be caused by problems with any of these components. Urinary incontinence is a symptom, not a disease. Some of the causes include normal changes in muscles because of aging, birth defects, pelvic surgery, injuries to the pelvic region or the spinal cord, neurological diseases, multiple sclerosis, infection, degenerative changes associated with aging, and pregnancy and childbirth. For people with an overactive bladder and other types of urinary incontinence, it is important to consult a physician for an accurate diagnosis. A comprehensive evaluation includes a complete physical examination that focuses on the urinary and nervous systems, reproductive organs, and urine samples. Diagnostic tests include X-rays, blood work, a urine analysis, and examination of the bladder capacity, the amount of urine left in the bladder after urination. In many cases, patients will then be referred to an urologist, a physician who specializes in diseases of the urinary tract. Treatment depends on the severity of your urge incontinence. Your doctor can help you decide on a course of action. Treatment usually begins with one or more of these methods: pelvic muscle rehabilitation such as Kegel exercises, bladder retraining, avoidance of bladder irritants such as caffeine and alcohol, FDA-approved medications, and surgery.