Symptoms of OAB
With an overactive bladder, you may:
- Feel a sudden urge to urinate that’s difficult to control
- Experience urge incontinence — the involuntary loss of urine immediately following an urgent need to urinate
- Urinate frequently, usually eight or more times in 24 hours
- Awaken two or more times in the night to urinate (nocturia)
Although you may be able to get to the toilet in time when you sense an urge to urinate, unexpected frequent urination and nighttime urination can disrupt your life.
Causes of OAB
Normal bladder function
The kidneys produce urine, which drains into your bladder. When you urinate, urine passes from your bladder through an opening at the bottom and flows out a tube called the urethra (u-REE-thruh).
In women, the urethral opening is located just above the vagina. In men, the urethral opening is at the tip of the penis.
As your bladder fills, nerve signals sent to your brain eventually trigger the need to urinate. When you urinate, nerve signals coordinate the relaxation of the pelvic floor muscles and the muscles of the urethra (urinary sphincter muscles). The muscles of the bladder tighten (contract), pushing the urine out.
Involuntary bladder contractions
Overactive bladder occurs because the muscles of the bladder start to contract involuntarily even when the volume of urine in your bladder is low. This involuntary contraction creates the urgent need to urinate.
Contributing factors that may increase risk of overactive bladder:
- Neurological disorders, such as stroke and multiple sclerosis
- Diabetes
- Medications that cause a rapid increase in urine production or require that you take them with lots of fluids
- Acute urinary tract infections that can cause symptoms similar to an overactive bladder
- Abnormalities in the bladder, such as tumors or bladder stones
- Factors that obstruct bladder outflow — enlarged prostate, constipation or previous operations to treat other forms of incontinence
- Excess consumption of caffeine or alcohol
- Declining cognitive function due to aging, which may make it more difficult for your bladder to understand the signals it receives from your brain
- Difficulty walking, which can lead to bladder urgency if you’re unable to get to the bathroom quickly
- Incomplete bladder emptying, which may lead to symptoms of overactive bladder, as you have little urine storage space left
The specific cause of an overactive bladder may be unknown.