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What is the main cause of overactive bladder?

Overactive bladder is a collection of symptoms that may affect how often you pee and your urgency. Causes include abdominal trauma, infection, nerve damage, medications and certain fluids. Treatment includes changing certain behaviors, medications and nerve stimulation.

my.clevelandclinic.org - Overactive Bladder (OAB): Causes, Symptoms & Treatment

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No, overactive bladder doesn’t go away on its own. If you don’t treat OAB, your symptoms can get worse, the muscles in your bladder that help control when you pee can become weak and your pelvic floor tissues can get thinner.

Overactive bladder symptoms can cause stress and affect your quality of life.

Overactive bladder is common. It affects up to 33 million adults in the U.S., including as many as 30% of men and 40% of women. However, that number may be higher because many people may feel embarrassed and won’t get help. Overactive bladder is most common in people 65 and older. Women may have OAB at a younger age, usually around 45. Overactive bladder (OAB) is a combination of symptoms that may cause you to urinate (pee) more frequently, have uncontrollable urges to pee, experience incontinence and have to pee at night. Conditions or injuries that affect your detrusor muscle cause overactive bladder. Your detrusor muscle is a collection of smooth muscle fibers in the wall of your bladder. These conditions may include: A healthcare provider may order tests to help diagnose overactive bladder. These tests may include: They may also refer you to a urologist . A urologist is a doctor who specializes in diseases and conditions that affect your urinary tract and reproductive system. A healthcare provider can diagnose overactive bladder by reviewing your symptoms and conducting a physical examination of the organs around your pelvis and rectum. They may ask you questions such as:

Management and Treatment

How do you fix overactive bladder?

Different treatments can help fix your overactive bladder. Treatments may include changing certain behaviors, medications and nerve stimulation (neuromodulation).

What behavioral changes can I make to help fix overactive bladder?

You can make many changes to your behavior to help fix your overactive bladder. These include:

Keeping a bladder diary

A healthcare provider may ask you to keep a bladder diary for a few days. Noting what happened before you had an accident can help the provider determine the cause of your OAB. You’ll use your bladder diary to track:

What you drink.

How much you drink.

What you eat.

How often you pee.

When and how much pee you leak.

How often you feel an urgent need to pee.

When you were unable to reach the bathroom in time.

If anything caused you to pee, such as coughing, sneezing or laughing.

Monitoring your diet

Stop eating or cut back on drinks or foods that may cause bladder symptoms. These may include:

Tea.

Coffee.

Alcohol.

Caffeinated soft drinks.

Fruits and fruit juices.

Chocolate.

Tomatoes and tomato-based products.

Spicy and acidic foods and drinks.

Foods and drinks that contain artificial sweeteners, such as diet soft drinks and some chewing gums.

Maintaining bowel regularity

Constipation can place pressure on your bladder and affect your bladder function. You may be able to avoid constipation and reduce bladder symptoms by keeping healthy bowel habits. The following can help you maintain bowel regularity: Increase your fiber intake. Incorporate foods such as beans, pasta, oatmeal, bran cereal, whole wheat bread, fresh fruit and fresh vegetables into your diet.

Drink two to four extra glasses of water each day.

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Exercise regularly.

Managing your weight

Having overweight can put pressure on your bladder, which may contribute to bladder control problems. Maintaining a weight that’s healthy for you can reduce pressure on your bladder.

Stop using tobacco products

Cigarettes and other tobacco products can irritate your bladder muscle. Coughing spasms due to smoker’s cough can also cause leakage.

Bladder retraining

When you have OAB, your body conditions your bladder muscles to react a certain way. By resetting your bladder muscles, you may hold your pee better.

Bladder retraining teaches you how:

Resist feelings of urgency.

Delay going to the bathroom.

Pee according to a timetable instead of responding to feelings of urgency.

How do you reset an overactive bladder?

The following steps can help you reset your overactive bladder:

Start with your current voiding interval. Your voiding interval is how often you pee. For example, if you pee every hour on average, this is your current voiding interval. Record how often you pee in your bladder diary to determine your current voiding interval. Once you’ve established your current voiding interval, try to wait a few minutes between when you feel the need to pee and when you actually go to the bathroom. Over time, slowly increase the time between when you pee. If you develop urgency between the voiding intervals, take deep, slow breaths in and out of your mouth. Imagine yourself in a peaceful setting or use another relaxation technique until the urge passes. Once the urge passes, go to the bathroom. Empty your bladder regularly all day and night at first. Don’t wait until the last minute. For example, start by going to the bathroom every two hours. If you’re still dry after two hours, gradually increase the time between when you go to the bathroom. If you’re wet, decrease the time between when you go to the bathroom to once an hour. If you usually go every hour, try to increase the time between bathroom visits to one hour and 15 minutes. Once you can maintain your new schedule without an accident for at least a week, try to increase your voiding interval by an extra 15 minutes. Continue until you reach a schedule that makes you feel comfortable. Try to achieve a voiding interval of between two and four hours.

Stick to your schedule as much as possible.

How do I control urges when resetting my bladder?

Controlling your urges is a key step in resetting your bladder. The following strategies may help: Stop what you’re doing and stay put. Stand quietly or sit down, if possible. Remain as still as possible. When you’re still, it’s easier to control your urges. Squeeze your pelvic floor muscles quickly several times (Kegels). Don’t fully relax in between Kegels. Relax the rest of your body. Take several deep breaths to help you let go of any tension.

Concentrate on suppressing your urge to pee.

Wait until the urge goes away.

Walk to the bathroom at a normal pace. Don’t rush. Continue squeezing your pelvic floor muscles quickly while you walk. Patience is important. Retraining your bladder usually takes at least six to eight weeks to see results. Talk to a healthcare provider if you have any questions or aren’t happy with your progress. They may prescribe medications for you to take while you’re resetting your bladder to help you achieve the best outcome.

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Can nerve stimulation help overactive bladder?

Yes, nerve stimulation can help improve OAB. Your nerves help tell your brain that your bladder is full. By treating your nerves, you can improve your bladder control. Nerve stimulation is a reversible treatment. Healthcare providers only recommend it if other treatments don’t work.

There are several types of nerve stimulation treatments. These include:

Sacral nerve stimulation

Sacral nerve stimulation is a therapy that electrically stimulates the nerves that control your bladder. A healthcare provider will implant a small device called a neurotransmitter under the skin near your upper buttock (butt) area. The neurotransmitter sends mild electrical impulses through a wire near your sacral nerve. Your sacral nerve is a nerve in your lower back. The impulses help you control your bladder. Sacral nerve stimulation can reduce the number of times you have to use the bathroom or the number of times you accidentally leak pee. It’s overall very effective. It’s also an outpatient procedure, so you can go home afterward.

Percutaneous tibial nerve stimulation

Percutaneous tibial stimulation sends small nerve impulses to a nerve branch near your ankle. It helps stimulate bladder control. Percutaneous tibial nerve stimulation is an outpatient procedure. Many people need 12 weekly sessions and then monthly maintenance sessions afterward.

Botulinum toxin injections

Botox® is the most well-known botulinum toxin brand. A healthcare provider injects Botox into your bladder wall using a cystoscope. This therapy is very effective, even for patients who haven’t responded well to other therapies. A small number of people may have temporary urinary retention (difficulty peeing) after a Botox injection. Botox injections wear off over time. Most people need to repeat injections every six months.

What medications are used to treat overactive bladder?

As you’re retraining your bladder, a healthcare provider may prescribe medication. Medications can help restore normal bladder function. Commonly prescribed medications for overactive bladder include:

Anticholinergic medications

Anticholinergic medications help control muscle spasms in your bladder. A healthcare provider may prescribe:

Beta-3 adrenergic medication

Beta-3 adrenergic medications cause the detrusor muscles in your bladder to relax so your bladder can store more pee. A healthcare provider may prescribe:

How soon after treatment will I feel better?

Pelvic floor exercises and changes to your lifestyle may take six to eight weeks before you start to see results. Many medications start to relax your bladder muscles after a few hours. But they may take up to a month to work fully.

Botox should start to work after one to two weeks.

Most people start to see improvement after six nerve stimulation treatments. However, it may take up to 12 treatments to see results.

my.clevelandclinic.org - Overactive Bladder (OAB): Causes, Symptoms & Treatment

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