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Feature Article

Overactive Bladder in Women: Diagnosis & Treatment

By Robert Laciak, MD, Samaritan Urology - Corvallis

Overactive bladder can significantly affect a woman’s quality of life. 

Defined as a sudden desire to pass urine and difficulty to suppress that urge, overactive bladder can also lead to increased frequency of urination. Overactive bladder can occur with or without leakage of urine. It is a chronic condition with no guarantee of cure. However, steps can be taken to minimize symptoms and in many cases resolve the problem.

Your physician will ask about your health history to help diagnose and distinguish overactive bladder from other conditions. In addition, he may consider your medications, fluid intake and certain types of foods which may worsen overactive bladder symptoms. Physicians will also want to rule out a urinary tract infection or other causes of urgency.

A physical exam may be performed to check for other causes of symptoms. Vaginal prolapse and stress incontinence (leakage of urine with coughing, sneezing or laughing) can occur with overactive bladder and may need to be addressed.

Urodynamic studies may be performed if initial treatments fail. This involves placing a catheter in the bladder and another in the vagina or rectum to better evaluate the bladder. Cystoscopy is an office procedure where a small flexible camera is placed into the bladder through the urethra to better visualize the inside of the bladder. This is performed to rule out other causes of urinary urgency such as bladder tumors.

There are many options for the treatment of overactive bladder from non-invasive to invasive procedures. The goal is to begin with the least invasive and proceed to more invasive procedures if initial treatments fail. It is important to understand that each of these treatments needs time to work. Additionally, while one treatment may have worked for one patient it may not work for another.

Treatment options include, but are not limited to, behavioral modifications (diet, exercise, weight loss and smoking cessation), physical therapy, medications, tibial nerve stimulation, electrical stimulation to the spine and Botox.

Overactive bladder is a common condition which should not be left untreated. Persistent incontinence can lead to increased urinary tract infections and hospitalizations. While this can be a chronic condition, treatment modalities exist to improve a patient’s quality of life.

An estimated 24 percent of adult women in the United States suffer from some form of urinary incontinence, but in many cases it is not necessary to live with these conditions.