What Is Overactive Bladder?

Overactive bladder (OAB) is not a single disorder but a group of bladder-related symptoms that cause frequent, sudden urges to urinate. People with OAB may find themselves needing to urinate many times a day and often during the night and may struggle to control the urge once it appears.

The symptoms of overactive bladder include:

• Nocturia: waking to urinate more than twice a night
• Urinary incontinence: leaking urine involuntarily when feeling the urge to urinate
• Frequent urination: urinating eight or more times in a 24-hour period

An overactive bladder occurs when the muscles of the bladder tighten involuntarily, even when the bladder is only partially full. These involuntary contractions can be caused by a variety of medical conditions and lifestyle factors, including:

• Diabetes
• Hormonal changes after menopause
• Urinary tract infections
• Neurologic conditions, such as stroke
• Bladder stones
• Caffeine or alcohol consumption
• Medications that increase urine production
• Difficulty emptying the bladder completely

What Are the Treatment Options for Overactive Bladder?

There are many effective ways to treat OAB, depending on the cause and severity of symptoms.

Treatment options include:

• Nerve stimulation therapies, including sacral nerve stimulation and percutaneous tibial nerve stimulation. Our team performed the first implantations in New England of the FDA-approved Altaviva device, a small device implanted near the ankle above the tibial nerve to manage bladder control symptoms. This is a minimally invasive procedure that requires no sedation or radiation. The device can last up to 15 years, typically requiring recharging only once or twice a year for about 30 minutes.
• Behavioral therapies: Techniques such as bladder training, biofeedback, weight loss, and intermittent catheterization can help restore bladder control.
• Lifestyle changes: Adjusting fluid intake, reducing caffeine or alcohol, and performing pelvic floor exercises can improve symptoms.
• Medication therapy: Various medications can relax the bladder, increase bladder capacity, or reduce urgency. For postmenopausal women, vaginal estrogen therapy can also help. Common medications include fesoterodine, oxybutynin, solifenacin, and mirabegron.
• Bladder injections: Botox injections can relax the bladder muscles and reduce involuntary contractions.
• Surgical options: In rare cases, surgery may be used to enlarge bladder capacity or, if necessary, remove the bladder.

Frequently Asked Questions