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.

This condition affects millions of people worldwide. According to a 2025 research review, it may occur in 20% of the global population and affects more women than men.

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.

But there are several treatments available that can help you manage your symptoms. Treating OAB can improve the outlook for the condition and reduce the frequency of incontinence.

Experiencing occasional incontinence doesn’t mean you have OAB. Urine leakage can happen for other reasons. You might have some leakage when you laugh very hard, or you might experience incontinence if you’ve been fighting the urge to urinate for a long time.

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.

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. These medications include:

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

OAB medications may cause some side effects, including dry eyes, dry mouth, and constipation.

Botox

Small doses of Botox can temporarily paralyze or weaken your bladder muscles. This treatment can cause the muscles to contract less often, reducing symptoms of OAB. The effects of an injection typically last 6 to 9 months, so you may need repeated injections.

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.

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

But when you have OAB, your 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 caffeine, alcohol, or other bladder irritants
  • incomplete emptying of your bladder when urinating
  • bladder health conditions, such as bladder stones

The exact cause of OAB is unknown. 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.

Bladder function relies on good urinary tract health. The causes of OAB are often due to issues in your urinary tract.

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

Tests used to diagnose OAB include:

  • 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.
  • Physical examination: Your doctor might feel for tenderness around your abdomen and kidneys or check for an enlarged prostate.
  • Bladder scan: This test involves using ultrasound to measure the amount of urine left in your bladder after you urinate.
  • Urodynamic testing: This assortment of tests can assess your bladder’s ability to hold and store 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 women but also occurs in men. Studies suggest that up to 27% of men 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 men, attributing the symptoms to other conditions.

Symptoms of OAB in men include:

  • frequently feeling an urgent need to urinate
  • urinating up to eight times per day
  • experiencing urine leakage
  • not being able to control your urination

Many cases of OAB in men 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.

Women are more likely than men to report symptoms of OAB to a doctor. Studies suggest that up to 43% of women may experience OAB symptoms. However, the number may be higher since some people may not report their symptoms to a doctor at all.

OAB involves symptoms that cause you to need to urinate more frequently, including:

  • feeling a sudden urge to urinate
  • not being able to control your urination
  • urinating at least two times every night
  • urinating at least eight times every day

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

Treatment for OAB can include medication, surgery, physical exercises, and some other methods.

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.

Symptoms of OAB in children include:

  • having an urgent or frequent need to urinate
  • experiencing accidents or urine leaks
  • urinating more than eight times in a day
  • feeling as if they have not emptied their bladder completely when urinating

Symptoms of OAB become less common as children get older. With age, kids learn 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.

Causes of OAB in children include:

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

In most cases, a doctor will not recommend surgery unless you’ve tried all the other treatment options without finding relief.

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.

Cystoplasty

If your doctor thinks your OAB symptoms are occurring because your bladder is small, they may suggest this procedure to enlarge it. However, cystoplasty is typically reserved for people who have seen no improvements from other treatment options.

Bladder removal

In rare cases, your doctor may decide that removing your bladder is the only option to eliminate OAB symptoms and complications. When they do this, they will reroute urine from your kidneys to an ostomy bag outside your body.

This type of surgery is often highly effective, but it comes with risks and possible long-term complications.

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.

Diet-related factors that can interfere with urinary health include:

  • Carbonated drinks: Bubbly drinks can worsen OAB symptoms and irritate the muscles in your bladder.
  • Excessive fluid intake: Drinking enough water is important for your overall health, but if you drink too much water, you’ll need to urinate more often.
  • Fluid intake before bed: If you drink anything within 2 to 3 hours before bed, you might find that you wake up to urinate more often during the night.
  • Gluten sensitivity: People who have an allergy or sensitivity to gluten (a protein found in wheat-based foods like bread, pasta, and crackers) may experience more symptoms of OAB.
  • Caffeine: This stimulant may increase OAB symptoms. Caffeine is found in some types of soda, coffee, chocolate, ice cream, and some over-the-counter medications.
  • Irritating foods: Some people find that certain foods or ingredients increase their OAB symptoms. Examples include citrus fruits, tomato products, spicy foods, artificial sweeteners, alcoholic beverages, artificial flavorings, and preservatives.

As you figure out the best diet to reduce your OAB symptoms, your doctor might also suggest taking certain nutritional supplements to fill any nutrient gaps in your diet.

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

Vitamins and supplements

You might consider using 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
  • plant extracts such as corn silk and capsaicin

A 2025 study found that low magnesium levels may be associated with OAB, and some small, older studies have suggested that taking magnesium supplements may help reduce urinary symptoms. But more research is needed.

Small studies have also suggested that L-arginine supplementation may help reduce symptoms in people with certain urinary conditions, including men with lower urinary tract symptoms and women with interstitial cystitis. However, more studies are necessary to find out whether these supplements may be helpful for OAB.

Limited research suggests that increasing your intake of certain nutrients, such as vitamin D and calcium, may help reduce OAB symptoms.

But before you take any of these supplements, check with your doctor to make sure they’re safe for you. Some supplements can interfere with prescription medications.

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.

Essential oils

OAB is often the result of nerves firing and causing muscles to contract unexpectedly. Essential oils that can help calm these nerves and muscles may help you find symptom relief.

According to a 2024 research review, essential oils from plants such as ylang-ylang, Cucurbita pepo (pumpkin), and Vanilla planifolia may help reduce some urinary symptoms. A 2013 study also suggests that the scent of clary sage essential oil may help reduce stress during urinary exams in people who experience incontinence.

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. Cutting out foods that may irritate your bladder and cause urgency is one example of a homeopathic remedy.

Bladder training and muscle training can also 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.

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.

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.

A basic Kegel requires you to squeeze the muscles in your pelvic floor and hold for several seconds. If you’re unsure which muscles to isolate, imagine trying to stop the flow of urine. You can do this several times each day.

If you’d like to learn more about how to strengthen your pelvic floor, you can ask your doctor for a referral to a pelvic floor physical therapist.

Vaginal cones

If you find it too abstract or difficult to imagine using your pelvic floor muscles, using a device called a vaginal cone can help you isolate those muscles.

You place a cone inside your vagina and attempt to hold it in place with your pelvic floor muscles. You can do this at least once per day. As your muscles become stronger, you’ll be able to use heavier cones.

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 lengthen the time between when you feel an urge to urinate and when you actually urinate.

You can try this each time you need to urinate. Start with a short period, such as 3 minutes, and slowly build up.

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.

Nocturia is more common in people 60 years old and older, but 1 in 3 adults over 30 make two or more trips to the bathroom each night. Most adults can sleep for 6 to 8 hours without waking up, while others may need to wake up only once.

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.

Botox may be best known as a facial wrinkle reducer, but Botox injections have also shown great promise as a treatment for many medical conditions.

Most OAB medications aim to calm the muscles and nerves in your urinary tract. If these medications aren’t effective, your doctor might consider injecting Botox into your bladder muscles. This treatment can help calm the muscles and reduce OAB symptoms.

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.

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

If you have symptoms of OAB or difficulty controlling your bladder, 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.