Overactive bladder is a disorder that causes various symptoms, including a sudden, uncontrollable urge to urinate and a frequent need to go to the bathroom during both the day and the night. Some people also experience incontinence.
Overactive bladder is a common condition that affects both males and females. It can happen at any age, but it becomes more likely as people get older.
Having an overactive bladder can affect a person's work, social life, and sleep quality. In one study, 65% of people with an overactive bladder said that it affected their quality of life.
Effective treatment is available in many cases. A range of factors can lead to an overactive bladder, and the treatment will depend on the cause and whether the person experiences incontinence.
Options include home remedies, medication, surgery, and nerve stimulation. A doctor can help an individual find the best approach.
In this article, learn more about how to manage an overactive bladder.
Find out more about the symptoms and causes of an overactive bladder in our dedicated article here.
A change in drinking habits may help relieve symptoms for some people.
Caffeine and alcohol can act as diuretics, which means that they can cause a person to produce more urine. Caffeine is present in coffee, tea, energy drinks, and many sodas.
Other drinks that may trigger additional urination include:
- carbonated beverages
- drinks containing artificial sweeteners
- cranberry juice
People may be able to minimize nighttime symptoms by reducing their intake of liquids just before bed.
It can be tempting to try to reduce urine production by drinking less fluid overall. However, this can lead to dehydration. In addition, concentrated urine can irritate the bladder and make symptoms worse.
Some foods, including spicy foods and acidic foods — such as orange juice and tomato sauce, can also irritate the bladder and exacerbate the symptoms of an overactive bladder.
Various lifestyle remedies may help reduce symptoms.
Obesity is a risk factor for an overactive bladder, possibly because the additional weight puts pressure on the pelvic floor. Losing weight may relieve symptoms.
Experts have linked smoking with symptoms of an overactive bladder in both males and females.
Pelvic floor exercises
These exercises, which people often call Kegel exercises, aim to strengthen the muscles that control urination. They involve tightening, holding, and then relaxing the muscles that the body uses to urinate. People can perform these exercises anywhere, at any time, but it is best to empty the bladder first.
Electrical stimulation of muscles
Doctors may also achieve the effects of pelvic floor exercises through electrical stimulation of the same muscles.
The urge to urinate occurs when the bladder contracts. When a person has an overactive bladder, the bladder starts to contract before it is full. A person can feel as though they need to urinate and then find that there is no urine to expel.
In bladder training, a person resists the urge to urinate. The aim of this is to train the bladder to become used to holding more urine. Bladder training can take time, and it can require patience.
A person usually begins by resisting the urge to urinate for just a few minutes. They gradually build up until they can wait an hour or more between bathroom visits.
This technique is only suitable for people with an overactive bladder, and it needs a doctor's guidance.
Biofeedback gives a person the chance to monitor how certain actions affect their body.
For example, to determine how effective a movement or exercise is, a person might carry out pelvic floor exercises with a probe inside the vagina (for females) or anus (for males). This device sends information to a computer screen so that the person can see real-time feedback.
Getting this feedback can help the individual become more aware of what works and what to avoid.
While a person is waiting for effective treatment, or if treatment does not work, the following products may help them manage their symptoms if they experience incontinence:
- incontinence pads or pants
- a handheld urinal
- a catheter for draining urine
- devices to prevent leakage, for example, while exercising
Learn more here about how to do Kegel exercises.
Some people may find medications beneficial. A person should follow their doctor's instructions when using medications, and they may need to attend follow-up sessions so that the doctor can monitor them for adverse effects.
Diuretics and antidiuretics
These include antidiuretic drugs, such as desmopressin (DDAVP).
For people who primarily have a problem with urinating at night, a doctor may prescribe a diuretic to take in the late afternoon.
A doctor may prescribe these for an overactive bladder or incontinence. Examples include oxybutynin (Ditropan) and tolterodine (Detrol).
Mirabegron (Myrbetriq) can help treat an overactive bladder by relaxing the bladder, which helps it fill and store urine.
Medications can produce adverse effects, some of which can be severe. A doctor should discuss these with the individual and monitor their use of the drugs.
Depending on the cause and symptoms of overactive bladder, surgery may be an option if other treatments do not help.
Adapting or repairing damage to urinary organs may help relieve symptoms.
The choice of procedure will depend to some extent on the cause of overactive bladder, the person's sex, and the severity of the symptoms of urinary incontinence.
Options for surgical procedures include:
- lifting the neck of the bladder (colposuspension)
- putting a sling around part of the bladder (sling surgery)
- inserting a mesh into the urethra (vaginal mesh surgery)
- injecting urethral bulking agents to increase the size of the urethral walls
- fitting a sphincter, a ring of muscle that can help control urine flow
- injecting botulinum toxin (Botox) to relax the bladder
- increasing the size of the bladder
- diverting urine outside the body
- inserting a catheter to manage overflow
A doctor will usually recommend surgery only as a last resort or for specific cases.
Nerve stimulation is a relatively simple and promising treatment for an overactive bladder. This treatment may help people whose symptoms do not respond to lifestyle changes or medication. It may also be beneficial for those who experience adverse effects from the drugs.
Nerve stimulation involves sending mild electric currents to the muscles of the pelvis and lower back that play a role in urination. It can either help the muscles contract or encourage the growth of helpful nerve cells in the area.
There are two main ways of performing nerve stimulation:
Percutaneous tibial nerve stimulation (PTNS): A professional puts a small electrode through the skin of the lower leg. A device sends pulses of electricity to the electrode, which stimulates a nerve in the leg. This, in turn, stimulates a nerve in the lower back that is responsible for controlling the bladder.
Sacral nerve stimulation (SNS): SNS uses the same process as PTNS, but the professional will place the electrode under the skin just above the buttocks. They use this to stimulate the nerve in the lower back that helps control bladder storage and the urge to urinate.
Learn more here about home and natural remedies for an overactive bladder.
One of the first steps in resolving an overactive bladder is to keep a journal of urinary habits and any other symptoms for about a week.
Doing this can help the individual understand what helps and what makes symptoms worse. It can also help them explain the issues to a doctor.
The person should record:
- all of the fluids that they consume
- when and how often they urinate
- any cases of accidental leakage
- reasons for any leakage, such as laughing or coughing
- any leakage that occurs while sleeping or with no apparent trigger
Different conditions can result in unwanted urination patterns.
A person with urinary incontinence will often find it hard to control urination. Leakage can occur when they cough, for example, or for no apparent reason. Various underlying factors can cause different types of urinary incontinence. Find out more in this article.
A person with frequent urination will have control over their bladder, but they will urinate more often than usual. Learn more about frequent urination here.
An overactive bladder can affect a person's quality of life, but treatment is available. Anyone who has concerns about urination should speak to a doctor.
A variety of factors can lead to urinary problems. With a correct diagnosis, there is a good chance of finding a suitable and effective treatment option.