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OAB: The Alphabet Soup of Incontinence

Overactive bladder, or OAB, seems like a confusing term. Is it just another way of saying urge incontinence? There are similarities: The problem is with the bladder's storage ability, and it causes the urge to urinate. However, though the urge may be difficult to suppress, it doesn't always mean leakage, or the involuntary loss of urine that is the definition of incontinence.

Specifically, OAB includes feeling a strong and sudden urge to urinate and the need to go frequently. You may have to use the bathroom every three hours or less, including in the middle of the night—waking up sometimes two or more times. The differentiating point is that OAB symptoms don't always lead to the involuntary leakage of urge incontinence…but there is the possibility that it can.

With OAB, you might feel like you're in a kind of limbo. Although you may be able to get to the bathroom in time, the uncertainty of “Will I make it in time?” can be stressful. The frequency, the need to drop everything and run to the bathroom and having interrupted sleep every night can turn your life upside down and wear you down.

Tracking down the cause of your OAB may provide answers. For many, OAB is due to an involuntary contraction of the bladder muscles, which causes that feeling of urgency. Why this is happening should be investigated by your doctor or urologist, to ease OAB and/or determine if there is an underlying medical condition that needs treatment. Possible medical causes include poor kidney function, diabetes, an enlarged prostate, a bladder stone or tumor, or even Parkinson's disease, stroke or multiple sclerosis. But it can also be as simple to remedy as a urinary tract infection, a medication that causes a fast increase in urine production or even just drinking too many liquids or the wrong liquids, like caffeinated beverages or alcohol. You won't know until you ask. Remember, silence isn't an option

Because it is often caused by problems with nerves and muscle, there are treatments that can help, especially if your symptoms are limited to urgency and frequency, rather than leakage.

Everyday habits to talk to your doctor about changing:

  • Drinking smaller amounts at a time and cutting out beverages after a certain hour in the evening, Ask your doctor how much fluid you need daily—you don't want to risk dehydration to correct OAB, but you may be able to drink less. Eliminating caffeinated drinks, which act like a diuretic, may help, too.
  • Creating a schedule for bladder training—you actually delay going to the bathroom for a few minutes when you feel the urge, and over time increase the length of the delay to hours. This may be done in conjunction with a bathroom schedule—you use the toilet at set intervals, again to retrain your bladder.
  • Double voiding—this is a technique that helps you more fully empty your bladder. After urinating, you wait a few minutes and then try to go again, to empty your bladder more completely.
  • Exercises called Kegels. They strengthen your pelvic floor muscles and urinary sphincter—muscles that hold in urine even if your bladder muscles involuntarily contract.
  • Give yourself peace of mind by wearing discreet incontinence pads or undergarments to protect clothes and avoid embarrassment if you do have any leakage—this way, you won't have to alter your lifestyle and risk lowering your quality of life.


Talk to your doctor about the right way to implement these approaches as well as stronger medical intervention–everything from a new class of drugs that can help alleviate OAB symptoms and reduce the number of episodes of urge incontinence to using a catheter to help empty the bladder more completely to surgical techniques to repair physical problems.