Overactive bladder (OAB) affects nearly 20% of the adult population.  The defining symptom of OAB is urgency, a sudden, compelling desire to urinate that is difficult to defer.  Normally as the bladder fills, the urge to urinate slowly increases and can be controlled for a period of time.  However with OAB the desire to urinate begins quickly, regardless of whether or not the bladder is full, and is difficult to control.  OAB is oftens associated with frequency, needing to urinate over 8 times in 24 hours, and nocturia, waking up 2 or more times during the night to urinate.

Additionally, almost half of OAB patients suffer from incontinence, the involuntary leakage of urine.  Not all people with OAB need treatment.  However, for some with OAB, the symptoms are extremely bothersome and can impair their social lives, work productivity, and emotional well-being. In the elderly, OAB can lead to an increase risk for falls and fall-related fractures. 

Many conditions such as urinary tract infections can cause symptoms similar to OAB and should first be excluded.  The good news is there are many treatment options available for those with OAB.  Read on to learn about a few of them from Anh-Hong Tran, M.D., urologist on the Baylor Plano medical staff.

1. Behavioral Therapy. 

• Kegel Exercises: Performing these exercises can help build up the pelvic floor muscles which are important in urinary continence and have been shown to help alleviate urgency. Learn more about performing Kegel exercises.
• Bladder retraining: - This involves urinating at scheduled times to help retrain your body to feel the urge to urinate less frequently and assist in decreasing the number of urgency episodes.  When you begin, you might need to plan short intervals, but you should be able to slowly increase by 1/2 hour periods until you only need to urinate every three to four hours without experiencing leakage.
• Stop smoking: Smoking can cause increased coughing, and coughing increases abdominal pressure, which can cause urine leakage.

2. Medications. If behavioral therapy does not lead to adequate improvement, there are a number of medications that have been proven to be effective.  The most common type of drug used to treat OAB is called an anti-muscarinics, and they help to relax the bladder, preventing contractions as the bladder fills.  These medications must be prescribed by your doctor.  

3. Surgery. In appropriate candidates, botox injection of the bladder can lead to significant improvement of OAB symptoms for six to nine months at a time. Others may be good candidates for a procedure called sacral neuromodulation whereby a small electrode and generator is implanted in the lower back to stimulate the sacral nerves, which are involved in bladder sensation and function.