Overactive Bladder

Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Dennis Lee, MD

• What is an overactive bladder?
• What are symptoms of an overactive bladder?
• What are treatments for an overactive bladder?
• What are treatments for the chronically incontinent?
• Overactive Bladder At A Glance

What is an overactive bladder?

An overactive bladder is a condition that results from sudden, involuntary contraction of the muscle in the wall of the urinary bladder. Overactive bladder causes a sudden and unstoppable need to urinate (urinary urgency). Overactive bladder is also referred to as urge incontinence and is a form of urinary incontinence (unintentional loss of urine).

Overactive bladder is especially common in older adults. Overactive bladder affects an estimated one in 11 adults in the United States. Overactive bladder, however, should not be considered a normal part of aging.

What are symptoms of an overactive bladder?

The symptoms of an overactive bladder include frequent urination, urgency of urination, and urge incontinence. Overactive bladder may cause significant social, psychological, occupational, domestic, physical, and sexual problems. Again, these symptoms should not be considered a normal part of aging.

What are treatments for an overactive bladder?

The treatment for overactive bladder depends on the capabilities of the patient. Here are commonly recommended treatments:

Pelvic muscle rehabilitation to improve pelvic muscle tone and prevent leakage

• Kegel exercises: Regular, daily exercising of pelvic muscles can improve, and even prevent, urinary incontinence. This is particularly helpful for younger women. These exercises should be performed 30-80 times daily for at least eight weeks.



• Biofeedback: Used in conjunction with Kegel exercises, biofeedback helps people gain awareness and control of their pelvic muscles.



• Vaginal weight training: Small weights are held within the vagina by tightening the vaginal muscles. These exercises should be performed for 15 minutes, twice daily, for four to six weeks.



• Pelvic-floor electrical stimulation: Mild electrical pulses stimulate muscle contractions. This should be done in conjunction with Kegel exercises.

Behavioral therapies to help people regain control of their bladder

• Bladder training teaches people to resist the urge to void and gradually expand the intervals between voiding.



• Toileting assistance uses routine or scheduled toileting, habit-training schedules, and prompted voiding to empty the bladder regularly to prevent leaking.

Medications for overactive bladder to improve incontinence medically

• Oxybutynin (Ditropan) prevents urge incontinence by relaxing sphincter muscles.



• Tolterodine (Detrol, Detrol LA) is indicated for the treatment of an overactive bladder with symptoms of urinary frequency, urgency, or urge incontinence.



• Estrogen, either oral or vaginal, may be helpful in conjunction with other treatments for postmenopausal women with urinary incontinence.

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