Overactive bladder is a syndrome that is diagnosed by its symptoms. Patients with overactive bladder usually experience urinary frequency. How frequent is too frequent? Most guidelines say eight or more trips to the bathroom to urinate per day. Urinary frequency can result from drinking excess fluids, but in patients with overactive bladder, the frequency has more to do with how much the bladder can comfortably hold. While most people can easily hold between 10 and 20 ounces, those with overactive bladder often feel like they have a full bladder with as little as 2-3 ounces. This results in more frequent trips to the bathroom, even if you decrease your fluid intake.

Another feature common in overactive bladder is urinary urgency. Urgency is described as an uncomfortable need to urinate, a feeling that urinating is difficult to postpone. Urinary urgency can lead to urinary frequency. It can make you feel like you are chained to the bathroom. We often describe the “warning time” for urination; that is the time from when you have a first desire to urinate until you feel like you can’t control your urination. That warning time can be minutes or hours in a normal bladder but patients with overactive bladder sometimes have only seconds. One goal of treatment for overactive bladder is to increase your warning time. That helps you regain control over your life.

Related to warning time and urinary urgency is urgency incontinence. This is the most common type of bladder leakage in patients with overactive bladder and can result in frequent incontinence. Many patients describe this as losing control of their bladder or just urinating when they don’t want to, so the term “leakage” can be confusing. Some people may not even notice this as a strong urge because they have become accustomed to it. But incontinence that occurs when you are not doing something strenuous, such as sleeping, watching TV, washing dishes or walking to the bathroom, is usually urgency incontinence.

What causes overactive bladder?

It is not clear why any person develops an overactive bladder. There are numerous factors suspected of worsening symptoms but none of these, on their own, fully explains overactive bladder. Some of these factors can include obesity, smoking, advanced age and consuming irritating foods or beverages. Particularly with irritating foods and beverages such as caffeine or acids, reduction can improve bladder symptoms. But plenty of people have continued symptoms of overactive bladder even without eating or drinking anything irritating.

When should you see a urologist for overactive bladder?

Most people with symptoms of overactive bladder do not require extensive or invasive evaluation. However, you should be aware that certain symptoms increase the possibility of a more serious condition and should have a more extensive evaluation by a urologist. For instance, sudden onset of symptoms, especially if accompanied by pain (which is not a symptom of overactive bladder), often indicates another problem such as an infection or a urinary tract stone. Blood that you see mixed into your urine is also not a symptom of overactive bladder and should be investigated by a urologist.

When visiting with your urologist, you will go over your symptoms and what treatment options might be best. To treat pelvic health conditions, including overactive bladder, Ochsner offers a wide range of treatment options ranging from lifestyle changes and medication to innovative procedures and robotic surgery. We offer a multidisciplinary approach to pelvic health care that is unique to our region. What’s more, we do it in a caring, compassionate setting.