Overactive bladder (OAB)

Overview

OAB describes a group of urinary symptoms driven by the bladder signalling a need to empty too often or too strongly. It can affect anyone and becomes more common with age, but it is a treatable condition rather than something to accept.

Symptoms

The main symptoms are urinary urgency (a sudden, compelling need to urinate), frequency (going more often than expected), and nocturia (waking at night to urinate). Some people also have urge incontinence — leakage that follows the urge.

Causes and contributing factors

The cause is often not a single problem. Bladder muscle overactivity, nerve signalling, fluid and caffeine intake, some medicines, constipation, and other health conditions can all contribute. An infection or other bladder problem can cause similar symptoms, which is why assessment matters.

When to seek medical care

See a clinician if urinary symptoms are bothersome, are new or changing, or come with pain, blood in the urine, fever, or difficulty passing urine. These may point to a different problem that needs prompt attention.

How it is assessed

Assessment usually includes a symptom history, a bladder diary, a physical examination, and a urinalysis to look for infection or other findings. Further tests are used only when the picture is unclear or symptoms do not respond to first steps.

Treatment options

Care is usually stepwise and individualised: lifestyle and fluid adjustments, bladder training and pelvic-floor exercises first; medicines that calm the bladder if needed; and, for symptoms that persist, options such as nerve-based therapies or bladder injections discussed with a specialist.

Questions to ask a clinician

• Could an infection or another problem be causing my symptoms?
• Would a bladder diary help us understand the pattern?
• Which lifestyle changes are most likely to help me?
• What are the benefits and side effects of bladder medicines?
• What options exist if first treatments do not work?