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UrologicalICD-10: N32.81Affects about 33 million adults in the United States

Overactive Bladder

Also known as: OAB, Urge Incontinence

Overactive bladder (OAB) is a condition characterized by a sudden, uncontrollable urge to urinate, often accompanied by increased frequency (8+ times per day) and nocturia (waking at night to urinate). In some cases, OAB leads to urge incontinence, the involuntary leakage of urine. It is not a normal part of aging and can be effectively treated with behavioral strategies, medications, and other therapies.

Symptoms

Sudden, intense urge to urinate that is hard to control
Urinary frequency (8 or more times in 24 hours)
Nocturia (waking 2+ times per night to urinate)
Urge urinary incontinence (involuntary urine leakage)
Anxiety about accessing a bathroom

Causes

  • Involuntary bladder muscle (detrusor) contractions
  • Neurological conditions (stroke, Parkinson's, multiple sclerosis, spinal cord injury)
  • Bladder outlet obstruction (enlarged prostate in men)
  • Bladder irritants (caffeine, alcohol, certain medications)

Risk Factors

  • Age (risk increases with age, though it is not inevitable)
  • Menopause and declining estrogen levels
  • Enlarged prostate (BPH) in men
  • Neurological disorders
  • Obesity
  • Diabetes

Diagnosis

  • Symptom questionnaire and voiding diary
  • Urinalysis to rule out infection or blood in urine
  • Post-void residual measurement by ultrasound
  • Urodynamic testing for complex cases

Treatment

  • Behavioral therapies (bladder training, timed voiding, fluid management)
  • Pelvic floor muscle exercises (Kegel exercises)
  • Anticholinergic medications (oxybutynin, tolterodine, solifenacin)
  • Beta-3 agonist (mirabegron, vibegron)
  • OnabotulinumtoxinA (Botox) bladder injections for refractory cases
  • Percutaneous tibial nerve stimulation (PTNS) or sacral neuromodulation

Prevention

  • Maintain a healthy weight
  • Limit caffeine and alcohol intake
  • Practice pelvic floor exercises regularly
  • Manage chronic conditions like diabetes that affect bladder function

When to See a Doctor

  • Urinary urgency and frequency disrupting daily life or sleep
  • Episodes of urinary incontinence
  • Blood in the urine (to rule out other conditions)
  • Urinary symptoms accompanied by pain or fever

Frequently Asked Questions

Related Conditions

Urinary Tract Infection

Urological

Multiple Sclerosis

Autoimmune

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.