Overactive bladder, also called OAB, causes a frequent and sudden urge to urinate that may be difficult to control. You may feel like you need to pass urine many times during the day and night, and may also experience unintentional loss of urine (urgency incontinence).
If you have an overactive bladder, you may feel embarrassed, isolate yourself, or limit your work and social life. The good news is that a brief evaluation can determine whether there's a specific cause for your overactive bladder symptoms.
You may be able to manage symptoms of an overactive bladder with simple behavioral strategies, such as dietary changes, timed voiding and bladder-holding techniques using your pelvic floor muscles.
Symptoms
If you have an overactive bladder, you may:
- Feel a sudden urge to urinate that's difficult to control
- Experience unintentional loss of urine immediately after an urgent need to urinate (urgency incontinence)
- Urinate frequently, usually eight or more times in 24 hours
- Wake up more than two times in the night to urinate (nocturia)
Even if you are able to get to the toilet in time when you sense an urge to urinate, unexpected frequent urination and nighttime urination can disrupt your life.
How a healthy bladder works
The kidneys produce urine, which drains into your bladder. When you urinate, urine passes from your bladder through a tube called the urethra. A muscle in the urethra called the sphincter opens to release urine out of the body.
In women, the urethral opening is located just above the vaginal opening. In men, the urethral opening is at the tip of the penis.
As your bladder fills, nerve signals sent to your brain eventually trigger the need to urinate. When you urinate, these nerve signals coordinate the relaxation of the pelvic floor muscles and the muscles of the urethra (urinary sphincter muscles). The muscles of the bladder tighten (contract), pushing the urine out.
Overactive bladder happens when the muscles of the bladder start to contract on their own even when the volume of urine in your bladder is low. These are called involuntary contractions, and they create an urgent need to urinate.
As you age, you're at increased risk of developing overactive bladder. You're also at higher risk of diseases and disorders, such as enlarged prostate and diabetes, which can contribute to other problems with bladder function.
Women who have an overactive bladder may also have a disorder called mixed incontinence, when both urgency and stress incontinence occur. Stress incontinence is the unintentional loss of urine prompted by physical movement or activity that puts pressure on your bladder, such as coughing, sneezing, laughing or exercising. Treatment of stress incontinence is not likely to help overactive bladder symptoms. Similarly, treatment of overactive bladder is not likely to improve stress incontinence symptoms.