Overactive bladder (OAB) causes a person to urinate more frequently and to feel a sudden and intense need to urinate. Urge incontinence occurs when this urge to urinate causes leaking. Although the two often occur together, they are not the same thing.
Because urge incontinence happens when a person feels an urgent need to urinate, many people with OAB experience it.
However, not everyone with OAB will get urge incontinence. Similarly, other conditions can cause urge incontinence aside from OAB.
Read on to learn more about the difference between overactive bladder versus urge incontinence.
OAB is a group of symptoms that causes sudden, intense urges to urinate. These urges often occur when the bladder is not full, and so a person may feel a need to urinate many more times per day than is typical.
Most guidelines suggest that the need to urinate up to seven times per day is typical, but more frequent urination may be a sign of OAB.
In contrast, incontinence
Urge incontinence means a person leaks urine following an intense and uncontrollable urge to urinate.
People with OAB can have urge incontinence, but not all do. Urge incontinence can also occur for other reasons.
The main symptom of urge incontinence is leaking urine after a person experiences an urge to urinate. This symptom can occur on its own, or it may result from something else, such as OAB.
OAB refers to a group of symptoms, which may or may not include incontinence. The other symptoms are:
- frequently urination at night, which may account for 20–33% of a person’s total urine output
- sudden intense urges to urinate
- urinating eight or more times during the day
- symptoms that disrupt daily life or that a person perceives as annoying
Doctors diagnose both OAB and urge incontinence based on symptoms. They will ask a person about their symptoms, how often they occur, and at what time of day.
They may ask someone to keep a urination diary for a few weeks. This can give the doctor more information on which to base a diagnosis.
A doctor may recommend some tests to rule out other problems. This may include:
- a pelvic examination
- tests for infections
- scans of the bladder or kidneys
- urodynamic testing, which measures how well the bladder stores and releases urine
A doctor can distinguish OAB from urge incontinence based on the presence or absence of urine leakage.
If a person has the symptoms of OAB but no leaking, they do not have urge incontinence. If they only experience leaking but urinate a typical amount, something else may be causing the incontinence.
Treatment for both OAB and urge incontinence can vary depending on the symptoms a person has, the severity of the symptoms, and the underlying cause.
In mild cases, lifestyle changes may help with managing the symptoms. This could include:
- limiting fluid intake at night
- reducing or stopping caffeine use
- trying to go to the bathroom on a schedule, so that urgency is less likely
A person may also benefit from exercises to help strengthen the pelvic floor, such as Kegels. Physical therapy that focuses on the pelvic floor, or a type of therapy known as biofeedback, may add to this.
If lifestyle changes and exercises are not sufficient, a doctor may suggest:
- medications, which can relax the bladder muscle or reduce the amount of urine a person passes
- Botox injections, which also relax the bladder muscles to reduce urgency
- nerve stimulation, which may help in cases of OAB where the brain and bladder are not communicating as they should
It can help to identify the cause of OAB or incontinence, if possible. Some of the factors that can contribute include:
- medication side effects
- pelvic floor weakness
- hormone changes
- neurological conditions
- urinary tract infections (UTIs)
When there is an obvious cause, addressing it directly can lead to a significant improvement or recovery.
Stress incontinence is another form of incontinence that causes urine leakage. It occurs when a person accidentally urinates when the bladder muscles are under physical stress. For example, this
- runs or jumps
A person may leak just a little or fully urinate. In people with this condition, the urge to urinate and the incontinence are not present when the bladder is not under stress.
However, it is worth noting that people can have more than one type of incontinence at the same time.
Similarly to urge incontinence, stress incontinence often occurs when a person has an underlying medical condition. For example, injuries from giving birth and muscle strain during pregnancy may cause stress incontinence.
A UTI is an infection of the bladder. The symptoms
A person with a UTI may also experience:
- painful urination
- trouble urinating
- blood in the urine
If the infection spreads to the kidneys, a person may also experience:
If a person has new urinary symptoms and they do not get better on their own, they should contact a doctor. It is possible these could be symptoms of an infection or other underlying condition that needs treatment.
Overactive bladder (OAB) and urge incontinence can be related, but they are not the same thing. OAB is a group of symptoms that include frequent urination and feelings of urgency. Urge incontinence is specifically when the urge to urinate causes leaking.
A person can have OAB without urge incontinence, and vice versa. However, many people with OAB experience urge incontinence as a symptom.
Both OAB and urge incontinence can disrupt a person’s life and require them to plan their activities around access to a bathroom, but both conditions are treatable. Speak with a medical professional for help and support.