Overactive bladder Overactive bladder

Overactive Bladder

Do you have a strong, sudden urge to urinate that makes you fear you will leak urine if you can’t get to a bathroom immediately? Are you urinating frequently or getting up each night to urinate?

Visit Steinberg Urology for a consultation with our urologists to address your concerns, perform diagnosis and provide you on advice as to what treatments are likely to fit your individual circumstances.


Overactive bladder is a medical condition caused by involuntary contractions of muscles in the bladder. These spasms create an urgency to urinate, whether the bladder is full or not. Overactive bladder (OAB) is the name for a group of urinary symptoms. It is not a disease. It 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.

The urge occurs more frequently than is considered normal. If there’s urine in the bladder, it may leak at the same time the contraction occurs (known as urge incontinence). Nearly 1 in 5 Canadians of both genders over the age of 35 have overactive bladder.

If you have an overactive bladder, you may feel embarrassed, isolate yourself, or limit your work and social life. A brief evaluation can determine whether there’s a specific cause for your overactive bladder symptoms.

Without treatment, OAB symptoms can make it hard to get through the day without many trips to the bathroom. You may not want to go out with friends or go far from home because you’re afraid of being far from a bathroom. This makes many people feel lonely and isolated.

You don’t have to let OAB rule your life. OAB can be controlled. If you think you have OAB, see one of our urologists for a consultation and proper treatment.

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You don’t have to let OAB rule your life. OAB can be controlled. If you think you have OAB, see one of our urologists for a consultation and proper treatment.


The symptoms of overactive bladder include:

  • Sudden, strong urge to urinate.
  • Urinating frequently, usually eight or more times in 24 hours.
  • Inability to control the urge to urinate until bathroom is reached.
  • Severe cases can lead to incontinence.
  • Waking from sleep to urinate.

Many people mistakenly assume it is a natural part of aging and do not seek treatment that could alleviate their symptoms.

Overactive bladder can cause problems for patients in all aspects of their lives – professional, social and sexual. People with overactive bladder can struggle with depression, shame, isolation, and stress.

If your symptoms distress you or disrupt your life, talk to your doctor. Treatments are available that might help you. Discussing such a private matter with your doctor might not be easy, but it’s worthwhile to take that risk — especially if your symptoms disrupt your work schedule, social interactions and everyday activities.


Take a quiz on our website. Use your answers talk to your doctor about your symptoms. The quiz will assist your doctor to assess your symptoms and create a personalised management plan and and suitable treatment options.


Normal You decide when to go Overactive The bladder muscles forces you to go


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. 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.
Urine leakage and bladder control problems can have many possible causes.

Several conditions may contribute to signs and symptoms of overactive bladder, including:

Weaked pelvic muscles

Weaked pelvic muscles – muscles that have become stretched and weak due to pregnancy and childbirth, which in turn have let the bladder sag out of position and have stretched the opening of the urethra causing urine leakage.

Nerve damage

Sending signals to the brain and bladder to empty at the wrong time. Diseases that can cause nerve damage include diabetes, Parkinson’s, multiple sclerosis, and stroke. Trauma that can cause nerve damage includes pelvic or back surgery, herniated disc, and radiation.

Medications, alcohol, caffeine

These products can dull the nerves, affecting the signal to the brain, resulting in bladder overflow. Diuretics and caffeine can cause rapid bladder filling and may cause bladder leakage.


A urinary tract infection can irritate bladder.

Excess weight

Being overweight puts pressure on the bladder and contributes to urge incontinence.

Estrogen deficiency after menopause

Estrogen deficiency after menopause may contribute to loss of urine due to urgency. Ask your doctor if vaginal-only estrogen therapy is right for you. This is different from “systemic” hormone therapy, which is absorbed throughout the body.

Abnormalities in the bladder

Abnormalities in the bladder, such as tumors or bladder stones.

Factors that obstruct bladder outflow

Enlarged prostate, pregnancy, constipation or previous operations to treat other forms of incontinence.

Declining cognitive function

Declining cognitive function due to aging, which may make it more difficult for your bladder to understand the signals it receives from your brain.


As you age, you’re at increased risk of developing overactive bladder. You’re also at higher risk of diseases and disorders, such as enlarged prostate and diabetes, which can contribute to other problems with bladder function.

Many people with cognitive decline — for instance, after a stroke or with Alzheimer’s disease — develop an overactive bladder. Incontinence that results from situations like this can be managed with fluid schedules, timed and prompted voiding, absorbent garments, and bowel programs.

Some women also may have a disorder called mixed incontinence, when both urge and stress incontinence occur. Stress incontinence is the loss of urine when you exert physical stress or pressure on your bladder, such as during activities that include running or jumping. Treatment of the stress incontinence is not likely to help the overactive bladder symptoms.

Older people may have a common combination of bladder storage problems and bladder-emptying issues. The bladder may cause a lot of urgency and even incontinence, but it doesn’t empty well. A specialist may be able to help you with this combination of bladder problems.

Life style factors

These healthy lifestyle choices may reduce your risk of overactive bladder:

  • Maintain a healthy weight.
  • Get regular, daily physical activity and exercise.
  • Limit consumption of caffeine and alcohol.
  • Quit smoking.
  • Manage chronic conditions, such as diabetes, that might contribute to overactive bladder symptoms.

Learn where your pelvic floor muscles are and then strengthen them by doing Kegel exercises — tighten (contract) muscles, hold the contraction for two seconds and relax muscles for three seconds. Work up to holding the contraction for five seconds and then 10 seconds at a time. Do three sets of 10 repetitions each day.


Your doctor will do a physical examination. He or she will ask what kinds of fluids you drink and how much. Your doctor will also want to know how often you urinate, how much, and if you leak. It may help to write down these things in a bladder diary for 2 or 3 days before you see your doctor.

The evaluation is aimed at quantifying the symptoms and looking for potentially reversible or significant causes of the symptoms. Evaluation may include:

  • A pelvic examination if you are a woman or a rectal examination if you are a man.
  • Urine test: Your health care provider may ask you to leave a sample of your urine to test for infection or blood.
  • Bladder scan: This type of ultrasound shows how much urine is still in the bladder after you go to the bathroom.
  • Cystoscopy involves passing a thin scope through the urinary tube (urethra) into the bladder to visually inspect the lower urinary system.
  • Your doctor may order a simple urodynamic test to assess the function of your bladder and its ability to empty steadily and completely.

Your doctor will review the results of any tests with you and suggest a treatment strategy.




Urodynamic Testing


Urinary Flow Test


Bladder Ultrasound


Lab Test




The symptoms of overactive bladder are treatable. The doctor may ask you to keep a voiding journal – a record of your urges, frequency, incontinence and fluid consumption.

There are many types of response to overactive bladder:


Anticholinergics: These pills or patches help to reduce the spasms of muscles in the bladder. They are particularly effective when paired with bladder training. The goal of medication is to improve your symptoms of urinary urgency, frequency and leakage while minimizing the side effects.


  • Bladder Training: Teaching yourself to increase the time you have before you urinate
  • Biofeedback: A technique for learning to control a body function that is not normally under conscious control



Botulinum toxins injections into the bladder muscle may benefit women with incontinence due to overactive bladder. It is used to treat UI when other medicines or self-care treatments don’t work. Injecting botulinum toxins into the bladder relaxes it, which makes more room for urine and lowers the chances of developing UI.


A breakthrough treatment solution that can optimize pelvic floor muscle resilience. BTL EMSELLA™ is a great option for men & women of any age who desire solution for overactive bladder and improvement in their quality of life.


The diVa laser treatment is the newest evolution of laser vaginal therapy built on years of experience. The treatment is quick and we can target specific regions to improve stress urinary incontinence or other localized issues – as well as the broader benefits in addressing dyspareunia or vaginal laxity.


Physiotherapy has a two-pronged approach: pelvic floor muscle rehabilitation and bladder retraining.

The images and/or videos are not presented as a guarantee of result. The results may vary. Patients gave their consent for the publication of images and/or videos.


At Steinberg Urology we pride ourselves on our compassionate care we offer to those facing challenges that affect their quality of life. Our urologists have years of experience and a commitment to excellence.

If you need to discuss this sensitive medical concern, schedule a consultation at our clinic in a safe confidential environment. Let us help you achieve optimal health and wellness in a professional setting.


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