Overactive Bladder (OAB)

Diagnosis and Treatment Options from Georgia Urology

Overactive Bladder (OAB) is Common, Abnormal But Treatable Condition

Overactive Bladder (OAB) is a type of bladder-control problem that occurs in both men and women and can negatively affect the overall quality of your life. Although OAB affects approximately 33 million Americans, many people are reluctant to talk about it. Some think having an overactive bladder is a natural part of aging.

While the symptoms of OAB may occur more often as people age, that does not mean it has to be a normal part of aging. For many, an overactive bladder does not have to interfere with their life.

Symptoms of OAB

There are four main symptoms of an overactive bladder:

  • Urgency: sudden uncontrollable overwhelming urge to urinate
  • Frequency: the need to urinate often
  • Urge Incontinence: leakage that follows an urge to urinate
  • Nocturia—the need to urinate often at night

These symptoms may occur daily or may be sporadic.

How Is OAB Diagnosed?

  • Bladder diary: a useful tool to record your intake, output, frequency, and leakage. Click here to fill out
  • Bladder Survey to evaluate the impact of OAB on quality of life and determine if treatment is working.
  • Urinalysis to test for infection, traces of blood, and other abnormalities.
  • Cystoscopy is not performed routinely unless we suspect bladder cancer or if the patient is experiencing bladder pain (to rule out kidney stones or interstitial cystitis) or significant obstructive symptoms.
  • Urodynamics (bladder pressure studies) measure bladder function. Learn more about Urodynamics
Send Us Your Bladder Diary   Learn More About Urodynamics

Causes & Risk Factors

OAB symptoms can stem from various factors, including UTIs, hormonal changes, medications, urinary blockages, and, in rare cases, neurologic disorders. Since pinpointing a single cause is often difficult, evaluation and treatment follow a stepwise approach. Risk factors can include:

Treatment Options

Treatment for overactive bladder (OAB) depends on your symptoms and how you respond to initial therapies. If behavioral changes or medications are not providing enough relief, several advanced treatment options are available.

These include Botox® for the bladder, percutaneous tibial nerve stimulation (PTNS), and neuromodulation therapies that target the nerves controlling bladder function.

Sacral neuromodulation (SNM) is an established therapy that uses a small implanted device to deliver gentle electrical stimulation to improve bladder control. Available systems include the Axonics Sacral Neuromodulation System and the InterStim System.

Newer implantable PTNS therapies offer additional minimally invasive options. These include the eCoin Peripheral Neurostimulator System and Altaviva System, which provide ongoing stimulation to help reduce urgency, frequency, and leakage.

Your provider will help determine the best treatment approach based on your individual needs and treatment goals.

Step 1: Conservative Treatment & First-Line Therapies

Conservative treatment for overactive bladder focuses on lifestyle changes, behavioral modifications, and medications to help manage symptoms before considering advanced therapies. We will work with you on:

  • Behavioral Modification/Education
  • Bladder Training
  • Pelvic Floor Physical Therapy
  • Bladder Control Strategies
  • Fluid Management
  • Medication

Step 2: Reassessment and Next Steps

Reevaluation typically occurs after a 6–12 week trial of conservative treatment. This allows us to assess your progress and determine whether additional therapies may be beneficial. In some cases, testing such as urodynamics or cystoscopy may be recommended to better understand the underlying cause of symptoms.

  • If symptoms improve: Continue conservative management with periodic follow-up.
  • If there is partial improvement: Adjust current strategies (e.g., medication type or dosage, pelvic floor therapy, bladder training) and consider advanced therapies.
  • If there is little or no improvement: Escalate to advanced treatment options, including bladder Botox® injections and nerve-based therapies such as PTNS, implantable PTNS, or sacral neuromodulation.

Step 3: Advanced Treatment Options

If conservative treatments do not provide sufficient relief, several advanced therapies are available. These minimally invasive options are designed to improve bladder control and reduce symptoms such as urgency, frequency, and leakage. Treatment selection depends on symptom severity, overall health, and patient preference.
Advanced therapies include:

These therapies work by modulating the nerves that influence bladder function and can provide long-term symptom relief for many patients.

Other Types of Incontinence

It is possible to have more than one type of incontinence at one time. Other types of incontinence can include:

  • Stress incontinence—urine leaking during physical activity or with sudden exertion such as sneezing, coughing, straining, laughing, etc.
  • Mixed incontinence—urine leaking after sudden urges due to OAB, as well as during physical activity
  • Non-obstructive urinary incontinence— difficulty with or an inability to completely empty the bladder
  • Accidental bowel leakage—an inability to control bowel movements which includes unexpected leaks and frequent trips to the bathroom

Each condition may be treated separately.

Discussing OAB with your physician can be the first step to getting help. Our dedicated team of medical professionals is committed to helping you on your personal journey through our OAB Treatment Pathway to help you obtain the highest bladder health possible. If you or someone you know is experiencing symptoms of OAB, contact us today for help!

Upcoming Free OAB Webinars

If you are having bladder or bowel accidents and find yourself planning your life around the bathroom, you are not alone.

Join us for upcoming webinars to learn about causes, symptoms, and treatment options for bladder and bowel concerns, including Urinary Incontinence and Overactive Bladder.

Register for our free online presentation with time for an anonymous Q&A session.

Check back for new webinar dates coming soon!

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