Key takeaways

  • Overactive bladder (OAB) is characterized by a frequent and urgent need to urinate, which may also include involuntary urine release and frequent urination, impacting quality of life due to its unpredictability.
  • Diagnosis of OAB involves a combination of urine testing, physical exams, bladder scans, and other specialized tests to identify underlying causes such as UTIs or bladder abnormalities.
  • Management of OAB includes pelvic floor therapy, medications like tolterodine and mirabegron, Botox injections to relax bladder muscles, nerve stimulation, and, in severe cases, surgical options to increase bladder capacity.

OAB causes a sudden urge to urinate. It can also trigger involuntary release of urine, known as incontinence.

The symptoms can be difficult to manage because OAB may be unpredictable. As a result, if you have this condition, you may feel the need to limit your social activities. That lack of social interaction may affect your quality of life and can lead to isolation and emotional distress.

However, several treatments are available to help you manage your symptoms. Treating OAB may help improve the outlook for the condition and reduce the frequency of incontinence. Read on to learn more about the condition and available treatments.

Experiencing occasional incontinence doesn’t mean you have OAB.

The frequency and urgency of urination determine an OAB diagnosis. Symptoms include:

  • an urgent and uncontrollable need to urinate
  • frequent involuntary release of urine
  • frequent urination (more than 8 times in 24 hours)
  • a pattern of waking up more than once per night to use the bathroom

Symptoms of OAB can change and might vary from person to person, so the condition can be difficult to identify without a doctor’s help. Knowing the symptoms of OAB can help you find better treatments faster.

The kidneys make urine, which travels to the bladder. Typically, the brain sends signals that tell the body to urinate, and then the pelvic floor muscles relax and allow urine to exit the body.

With OAB, the bladder muscles contract involuntarily. This causes you to feel like you need to urinate frequently, even if your bladder isn’t full.

Factors and conditions that can cause OAB symptoms include:

  • excessive fluid intake
  • medications that increase urine production
  • urinary tract infections (UTIs)
  • consumption of alcohol or other bladder irritants
  • incomplete emptying of your bladder when urinating

The risk of developing the condition increases with age. But OAB is not a typical part of aging, so it’s important not to ignore the symptoms if you experience them. Make an appointment with a doctor so you can get a diagnosis.

Several treatments are available to help you manage symptoms of OAB.

Pelvic floor physical therapy

Some physical therapists focus specifically on the pelvic muscles.

Through targeted muscle exercises and strengthening, a pelvic floor physical therapist can help you manage a variety of urinary problems, including urgency, frequency, and nighttime symptoms.

Medication

Medications that treat OAB have two primary effects: relieving symptoms and reducing episodes of urge and incontinence.

Examples of these medications include:

  • tolterodine (Detrol, Detrol LA)
  • trospium (Sanctura)
  • mirabegron (Myrbetriq)

Botox

Small doses of Botox can temporarily paralyze or weaken your bladder muscles. This treatment can reduce the frequency of muscle contractions, thereby reducing symptoms of OAB.

Botox injections for OAB are generally well tolerated with few side effects. The injection’s effects typically last 6 to 9 months. After that, your doctor might recommend another round of injections to manage your OAB symptoms.

Botox injections do have some possible complications. You can talk with your doctor about any concerns you have and whether Botox for OAB may be an option for you.

Percutaneous tibial nerve stimulation

This procedure changes the electrical signal of the nerves that carry impulses to your bladder. Healthcare professionals can perform the electrical stimulation using a small needle inserted through the skin of your lower leg.

Although many studies on this treatment have been small, some research has suggested that it can reduce frequency and urgency in people with OAB.

Surgery

If medication, nerve stimulation, or other therapies don’t help reduce your symptoms, your doctor might suggest surgery to increase your bladder’s capacity.

Sacral nerve stimulation

OAB is often the result of errant nerve impulses that tell your bladder you need to urinate when you don’t. These impulses may cause frequent urination or urges even when you’ve already urinated.

During a sacral nerve stimulation procedure, a doctor can place a small electrode under the skin of your buttocks or lower abdomen. This electrode will send pulses that help regulate the nerve signals that tell your body when you need to urinate.

Urinary diversion

Rerouting your ureters (the tubes that carry urine from your kidneys to your bladder) can reduce the frequency and urge to urinate.

During this procedure, your doctor will bypass your bladder and create an opening in your abdominal wall where urine can empty into an ostomy bag.

Bladder augmentation

If your doctor thinks your OAB symptoms are occurring because your bladder is small, they may suggest this procedure to enlarge it.

However, augmentation is typically reserved for people who have seen no improvement from other treatment options.

A doctor may use several tests to diagnose the cause of OAB symptoms. They might also refer to a urologist, a specialist who treats urinary tract conditions.

Tests used to diagnose OAB include:

  • Physical examination: Your doctor might feel for tenderness around your abdomen and kidneys or check for an enlarged prostate.
  • Urine testing (urinalysis): Healthcare professionals will test a sample of your urine for any abnormalities, including blood. A urinalysis can help identify a UTI or another urinary tract problem.
  • Bladder scan: This test involves using an ultrasound to measure the amount of urine left in your bladder after you urinate.
  • Urodynamic testing: This set of tests can assess your bladder’s ability to store and empty urine.
  • Cystoscopy: During this test, a doctor inserts a lighted scope into your bladder while you’re sedated. A cystoscopy helps your doctor identify whether your symptoms are due to any abnormalities within your bladder, such as bladder stones or tumors. A doctor might also take biopsies during this procedure.

Your doctor or urologist may use additional tests to help rule out or confirm an OAB diagnosis.

OAB is more common in females but also occurs in males. Studies suggest that up to 27% of males may have OAB, but that number could be higher because some men may not tell a doctor about their symptoms.

Additionally, doctors might misdiagnose OAB in males, attributing the symptoms to other conditions.

Many cases of OAB in males are the result of an enlarged prostate, which can block urine flow and make urinary incontinence more common.

An enlarged prostate becomes more common with age, particularly among those ages 60 years and older, so OAB is also more common in older people. In these cases, treating the prostate condition may ease symptoms of OAB.

Studies suggest that up to 43% of females may experience OAB symptoms. However, the number may be higher since some people may not report their symptoms to a doctor at all.

It’s not clear what causes OAB, but the symptoms may become more common after menopause, possibly as a result of decreased estrogen levels. However, OAB can occur at any age.

OAB is a common childhood condition, but not every instance of bedwetting is the result of OAB. While children often grow out of OAB symptoms, treatment can help prevent frequent urination or complications.

With age, a child learns to control their bladder and recognize signals that they need to urinate. If symptoms of OAB don’t seem to be resolving or are getting worse, talk with your child’s doctor.

Like those for adults, treatments for OAB in children focus on treating any underlying causes and preventing symptoms.

What you eat may directly affect your urinary health. Some types of foods and drinks can place stress on your bladder, increasing your risk of bladder irritation and OAB symptoms.

However, a food that affects you may not affect someone else. Keeping a food log can help you figure out which foods might make your symptoms worse.

Foods and drinks, and related factors, that can interfere with urinary health include:

  • carbonated drinks such as soda
  • excessive fluid intake
  • drinking a lot before bed
  • gluten sensitivity
  • caffeine
  • alcohol
  • tomato
  • citrus fruits and juices
  • raw onion
  • sour cream

In addition to any necessary medical treatment, some complementary treatments may help reduce OAB symptoms.

It’s always important to speak with a healthcare professional before trying any natural or complementary treatments.

Examples include the following:

  • Vitamins and minerals: Some people use some herbs, vitamins, and other supplements as alternative treatments for OAB. Examples include Chinese herbal blends such as gosha-junki-gan, mushroom extracts such as Ganoderma lucidum, and plant extracts such as corn silk and capsaicin. A 2025 study found that low magnesium levels may be associated with OAB.
  • Acupuncture: Acupuncture involves inserting fine-tipped needles into your skin in specific areas of your body. Activating these points is thought to restore the flow of energy, which may ease symptoms. According to a 2018 research review, acupuncture might help relieve OAB symptoms, but there’s not yet enough evidence to know whether it works.
  • Homeopathic remedies: This type of treatment relies on listening to your body and finding treatments that can address your whole body, not just your OAB symptoms. Bladder training and muscle training can be considered homeopathic. These methods can help you increase the length of time you can go between feeling an urge to urinate and actually urinating.

It’s always best to speak with a healthcare professional before trying natural remedies for OAB.

The muscles around your urinary tract help you hold urine when you have an urge. They also help you fully empty your bladder when you urinate.

Strengthening these muscles through exercise can be beneficial for managing OAB. You can work with a physical therapist to learn how to properly perform these techniques to help manage OAB.

Examples of exercises include:

  • Pelvic floor exercises: These exercises, also known as Kegels, can help you strengthen the muscles in and around your pelvis. The increased strength can help you stop and start urination more effectively so that you can potentially reduce unintentional urination.
  • Vaginal cones: If it is too difficult to imagine using pelvic floor muscles, using a device called a vaginal cone can help some people isolate those muscles.
  • Bladder training: Bladder training helps you hold your urine longer so you can reteach the muscles and nerves in your urinary tract. In other words, this strategy helps you delay urination by extending the time between the urge to urinate and the actual act of urination.

If you find that you wake up to urinate more than one time per night, you might have nocturia, or overactive bladder at night.

Nocturia is not the same as OAB. In fact, some people who don’t experience any OAB symptoms during the day still have nocturia.

If you’ve been waking up often to use the bathroom at night, you might be experiencing nocturia. Consider talking with a doctor about it.

Overactive bladder (OAB) can present challenges in everyday life, but doctor-prescribed treatments and lifestyle strategies may help you reduce the frequency of urges.

If you have symptoms of OAB, the most important thing you can do is talk with a doctor. OAB is often underreported.

Research has come a long way in helping doctors understand the potential causes and treatments for OAB. You and your doctor can work together to develop a treatment plan and address any concerns you may have.