Overactive bladder (OAB) is a chronic condition that does not go away by itself. OAB may worsen without treatment and negatively affect a person’s quality of life. However, there are many treatment options to help manage OAB.
OAB is a condition that causes a frequent and urgent need to urinate. This article examines whether symptoms of OAB come and go, the causes and risk factors of the condition, and options for managing OAB.
OAB is a long lasting, chronic condition that will not resolve on its own. Without treatment, OAB may worsen.
People with OAB may have symptoms that affect their daily life, including their relationships, work, sleep, sex life, exercise, and mental health.
Does OAB flare up, and if so, what can trigger it?Anonymous
I am unaware of any studies to confirm this. However, in 40 years in urology practice, I have had people whose OAB has good days and bad days. There could be various reasons for this, such as diet, stress, temporary illnesses, and medications. However, without research into this question, I cannot confirm this with any certainty.Roger Bielinski, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Symptoms of OAB can include:
- an urgent need to urinate, even after recently emptying the bladder
- increased frequency of urination
- unintentional urination immediately after experiencing an urgent need to urinate
- waking up in the night to urinate, known as nocturia
With typical bladder function, the bladder signals to the brain when it is full of urine. The bladder muscles can then squeeze urine out of the urethra when a person chooses to urinate.
OAB may occur if there is a problem in the signaling between the brain and bladder.
When the bladder is nearly full or full, a person should receive a signal from the brain indicating that they need to urinate. People with OAB may experience an urgent need to urinate. However, their body may not be able to keep urine in. The bladder may also receive signals to empty before it is full.
Overactive muscles in the bladder may also cause OAB. This results in the bladder muscles releasing urine even if the bladder is not full. The bladder muscles can generate enough pressure that the sphincter cannot hold the urine inside, leading to urine leakage.
Risk factors for OAB include:
- nervous system disorders or nerve damage that affects how the brain and bladder communicate
- hormonal changes
- pelvic muscle weakness or spasms
- urinary tract infection (UTI)
- side effects from certain medications
- stroke, multiple sclerosis (MS), or other conditions affecting the brain or spinal cord
OAB may cause similar symptoms similar to ones associated with other conditions. Other causes of bladder control problems can
- bladder infection
- older age, particularly for people over age 80 years old
- congenital anomalies (also known as birth defects)
- a blocked urinary tract, such as from a kidney stone or tumor
- chronic cough
- having overweight or obesity
- genitourinary fistula
- UTI, which may cause temporary symptoms
- stress urinary incontinence
Making certain lifestyle changes and trying certain management techniques may help people with OAB. These include:
- Diet: People may wish to avoid foods and drinks that can aggravate the bladder, such as caffeine, alcohol, soda, and chocolate.
- Diary: Keeping a diary to track urination frequency and diet may help to identify foods or drinks that trigger OAB symptoms.
- Double voiding: Double voiding is going to the toilet and emptying the bladder, waiting a few seconds, and then trying to empty it further.
- Delayed voiding: This is intentionally waiting a few minutes before going to the toilet. It helps to gradually increase the time people can wait before urinating.
- Timed urination: This involves following a daily schedule for using the bathroom, rather than responding to urges.
- Biofeedback: Biofeedback teaches people about their pelvic muscles and how they function.
- Pelvic muscle exercises: Examples of pelvic muscle exercises are Kegel exercises and quick flicks. These can help to relax and strengthen the pelvic floor muscles.
If people want to try delayed voiding or timed urination, it may be best to talk with a healthcare professional to determine a suitable schedule.
Learn about natural remedies for OAB here.
Medications and surgical treatment
If lifestyle changes are ineffective, medications or surgery may help. Medical treatments may include:
- Oral or transdermal medications: Examples include antimuscarinics or beta-3 agonists, which help relax the bladder muscles.
- Bladder Botox treatment: This uses Botulinum toxin, also known as Botox, to relax the bladder muscles. It may be effective for up to 6 months.
- Nerve stimulation: This uses electrical pulses to help the brain and bladder communicate more effectively.
- Surgery: Doctors may recommend surgery to enlarge the bladder or alter the route of urine flow for rare and severe cases of OAB.
OAB causes an urgent and frequent need to urinate. It may occur due to problems with how the brain and bladder communicate or due to overactive bladder muscles. People may find their symptoms come and go or they may stay consistent.
Treatments for OAB can help people effectively manage their condition. Without treatment, OAB may worsen as the bladder and pelvic floor muscles become weaker and thinner, increasing the frequency or severity of OAB symptoms.
Other bladder control problems may cause similar symptoms. It is important for a person to talk with a doctor if they have any symptoms of OAB.
OAB does not go away on its own and may worsen without treatment. Lifestyle changes, medical treatments, and sometimes surgery can help people effectively manage OAB.