The average person urinates about 6-8 times per day. However, the number of times a person urinates depends on factors like how much we drink, what we drink, medical conditions and the medications used to treat those conditions. 15 percent of women have a problem called overactive bladder (OAB), people with overactive bladder describe the frequent urge to urinate that is difficult to defer even while they sleep. One indication that you have an overactive bladder is that you feel the urge to urinate when the bladder is not full. The exact cause of bladder overactivity is unknown, but we suspect that discoordination between the nerves and bladder muscles are at the core of the problem.
To diagnose an overactive bladder your doctor will perform a physical exam, but urine tests looking for bladder infections and a bladder ultrasound which checks for how well your bladder empties will help confirm the diagnosis. A bladder diary is another tool which helps you track your urinary habits and often support the diagnosis of an overactive bladder.
How to manage Overactive Bladder
- Behavioral modification: What goes in must come out. Keep track of your fluid intake, drink when you are thirsty and limit your fluids to less than 64 ounces per day.
- Dietary changes: Certain drinks can stimulate an overactive bladder so try to limit drinks like coffee, tea, sodas, artificial sweeteners and alcoholic beverages.
- Pelvic Floor Physical therapy: Pelvic floor exercises or Kegel exercises can effectively treat symptoms of overactive bladder. Sometimes a pelvic floor physical therapist can help you identify the proper muscles and teach you useful urge suppression strategies.
- Bladder Training: Bladder training is the process by which you train your bladder to increase the time between the initial feeling to urinate and the time you actually urinate. This helps the bladder hold better and reduces the number of times you need to void daily.
- Medications: There are medications which work by relaxing the muscles of the bladder. These medications are very effective at treating overactive bladder and are typically prescribed by your doctor. These medications need to be taken every day and may cause symptoms like constipation and dry mouth.
- Botulinum Toxin (Botox): Botox is a medication usually administered in an office by a physician. It works by relaxing the bladder muscle which helps the bladder hold urine better, it also helps reduce the frequent urge to urinate. Botox wears off and typically you need to repeat injections about 1-2 times per year.
- Nerve Stimulation: Nerve stimulation works by either direct or indirect activation of nerves which control the bladder. One strategy utilizes special needles to activate the posterior tibial nerve in the leg and another strategy works by permanent implantation of a device near the spine to stimulate the sacral nerves.
I am board certified in Obsetrics and Gynecology (OBGYN) and Female Pelvic Medicine and Reconstructive Surgery (FPMRS). I currently serve as the Medical Director of Female Pelvic Medicine for the Crozer Health Medical Group in the greater Philadelphia area. I obtained my residency training in OBGYN at the Los Angeles County+ University of Southern California Medical Center and fellowship training in FPMRS at Johns Hopkins. I am passionate about the field of Women’s Health and the treatment of pelvic floor disorders like urinary incontinence and pelvic organ prolapse.