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Frequent nighttime urination
Frequent urination
Urine urgency
I feel urine remained after urination
It is difficult to pee
I am peeing again within in 2 hours
Peeing at night
Not seeing your symptoms? No worries!
This group of urinary symptoms causes patients to need to urinate frequently. They may also experience a sudden urge to urinate that is hard to control due to excessive bladder contractions.
Your doctor may ask these questions to check for this disease:
Behavior therapy, altering fluid intake, and maintaining regular bowel movements can help with symptoms. Medications may be changed if thought to be causing overactive bladder. New medications may also be prescribed to help control bladder contractions.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Nao Saito, MD (Urology)
After graduating from Tokyo Women's Medical University School of Medicine, Dr. Saito worked at Tokyo Women's Medical University Hospital, Toda Chuo General Hospital, Tokyo Women's Medical University Yachiyo Medical Center, and Ako Chuo Hospital before becoming Deputy Director (current position) at Takasaki Tower Clinic Department of Ophthalmology and Urology in April 2020.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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Q.
Frequent nighttime urination (Nocturia) can ruin your rest. Find out if it’s a bladder issue or a sign of a deeper sleep-related problem.
A.
Nocturia can come from bladder issues like overactive bladder or an enlarged prostate, sleep problems such as sleep apnea, or medical conditions like diabetes, heart failure, or kidney disease; waking five times a night is not normal and should be assessed. There are several factors and red flags to consider, along with practical first steps that can change your next move in care. See the complete guidance, urgent warning signs, and step‑by‑step recommendations below.
References:
* pubmed.ncbi.nlm.nih.gov/28189304/
* pubmed.ncbi.nlm.nih.gov/27666996/
* pubmed.ncbi.nlm.nih.gov/30990426/
* pubmed.ncbi.nlm.nih.gov/28652618/
* pubmed.ncbi.nlm.nih.gov/31559218/
Q.
Constant Urge? Why Your Bladder Needs Pumpkin Seeds + Medical Next Steps
A.
There are several factors to consider for a constant urge to urinate, from overactive bladder and UTIs to diabetes or prostate enlargement. Pumpkin seeds and pumpkin seed extract can modestly reduce urgency and frequency by supporting bladder muscle function and prostate health, but they are not a cure; see below for how to use them safely with other proven habits. If symptoms persist, worsen, or include red flags like pain, fever, blood in urine, back pain, or trouble emptying, seek medical care; below we outline the exact next steps and evidence-based treatments your doctor may recommend.
References:
* Nishimura M, Ohkawara T, Sato H, Takeda H, Nishihira J. Effects of pumpkin seed oil on the symptoms of overactive bladder. J Tradit Complement Med. 2014 Apr;4(2):109-113. doi: 10.4103/2225-4110.129379. PMID: 24860735; PMCID: PMC4032845.
* Shabir N, Khalid S, Ahmad A, Siddiqui Z, Anjum SI, Manzoor MF. Current perspective on the potential health benefits of Cucurbita pepo L. seeds. J Food Biochem. 2021 May;45(5):e13710. doi: 10.1111/jfbc.13710. Epub 2021 Mar 18. PMID: 33735749.
* Terashima N, Itoh Y, Ishida K, Inagaki N, Takeda H. Pumpkin Seed Extract as an Effective Complementary Therapy for Overactive Bladder in Postmenopausal Women. Int J Environ Res Public Health. 2022 Mar 9;19(6):3148. doi: 10.3390/ijerph19063148. PMID: 35328906; PMCID: PMC8954751.
* Vahlensieck W, Theurer C, Pfitzer E, Brauer H, Mayer TE. Effects of pumpkin seed oil on the prostate and bladder in benign prostatic hyperplasia: A randomized, placebo-controlled, double-blind trial. Urologe A. 2015 Mar;54(3):362-70. English, German. doi: 10.1007/s00120-015-3733-1. PMID: 25688647.
* Damiano R, De Sio M, Pizzo M, Cantiello F, Costantini E. Phytotherapy in the treatment of overactive bladder: a systematic review. Arch Ital Urol Androl. 2021 Dec 22;93(4):396-403. doi: 10.4081/aiua.2021.4.396. PMID: 34978184.
Q.
Tired of Bedwetting? Why Your Body Won’t Stop & Desmopressin Next Steps
A.
Bedwetting causes and desmopressin next steps, explained: it often stems from too much nighttime urine, a small or overactive bladder, deep sleep, genetics, or less common medical issues, and desmopressin lowers nighttime urine output but needs strict fluid limits to avoid low sodium. There are several factors to consider, including who is a good candidate, alternatives like alarms and bladder training, red flags that need medical evaluation, and what to do if desmopressin does not work; see complete details below to guide your next steps.
References:
* Vande Walle J, Rittig S, Mahler B, Schmidt P. Pathophysiology and treatment of primary nocturnal enuresis: an updated review. J Pediatr Urol. 2020 Feb;16(1):10-21. DOI: 10.1016/j.jpurol.2019.11.002. Epub 2019 Dec 11. PMID: 31839527.
* Vande Walle J, Rittig S. Desmopressin in the treatment of monosymptomatic nocturnal enuresis. Drugs. 2019 Aug;79(12):1289-1300. DOI: 10.1007/s40265-019-01150-1. PMID: 31317424.
* Neveus T, Fonseca E, Franco I, Kawauchi A, Kovacs L, Nieuwhof-Leppink AJ, Lottmann H, Mammina C, Rittig S, Robson WLM, Yeung CK. The 2018 International Children's Continence Society's guidelines for the management of nocturnal enuresis. J Pediatr Urol. 2020 Feb;16(1):22-30. DOI: 10.1016/j.jpurol.2019.06.027. Epub 2019 Jul 13. PMID: 31405786.
* von Gontard A, Söchting J, Kuntz B, Schlegl T, Wagner C, Möllhoff C, Eismann F, Vangeepuram N, Reiss C. The Genetics of Nocturnal Enuresis: A Systematic Review. J Urol. 2020 Jun;203(6):1227-1237. DOI: 10.1097/JU.0000000000000780. Epub 2020 Mar 5. PMID: 32134440.
* Franco I, von Gontard A, Lottmann H. Nocturnal enuresis in children: Current management and future perspectives. J Pediatr Urol. 2017 Aug;13(4):324-331. DOI: 10.1016/j.jpurol.2017.02.012. Epub 2017 Mar 30. PMID: 28434772.
Q.
Waking Up to Pee? Why Your Bladder Is Overactive & Medical Nocturia Steps
A.
Waking at night to urinate, called nocturia, is common and often tied to overactive bladder or making too much urine at night, but it can also signal reduced bladder capacity or broader issues like diabetes, sleep apnea, heart or kidney disease, or an enlarged prostate; there are several factors to consider, see below for what matters most. If you are up two or more times nightly or have red flags like pain or burning, blood in urine, swelling, chest symptoms, or excessive thirst, talk to a clinician. Evidence based steps include evening fluid and caffeine limits, leg elevation, bladder training and pelvic floor therapy, and medicines such as anticholinergics, beta 3 agonists, desmopressin, or prostate treatments, with a bladder diary and targeted tests guiding the right plan, and key details that could change your next steps are outlined below.
References:
* Leslie SW, D'Andrea MR. Nocturia: A Challenging Problem for Urologists and General Practitioners. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32644485.
* Weiss JP. Nocturia: current opinion on diagnosis and management. Int Urogynecol J. 2022 Nov;33(11):2877-2884. doi: 10.1007/s00192-022-05307-2. Epub 2022 Aug 2. PMID: 35917024.
* Chen Q, Zeng W, Zhang W, et al. Overactive bladder: current concepts and management. Transl Androl Urol. 2021 Jul;10(7):3165-3176. doi: 10.21037/tau-21-228. PMID: 34386226; PMCID: PMC8350438.
* Dube M, Kim S, Chung K, et al. Current and Future Pharmacotherapy for Nocturia. Rev Urol. 2020;22(4):173-182. PMID: 33408666; PMCID: PMC7778216.
* AUA Guideline of Guidelines Panel. Guideline of Guidelines for the Management of Nocturia. Urology. 2021 Nov;157:12-25. doi: 10.1016/j.urology.2021.05.059. Epub 2021 Jun 4. PMID: 34090906.
Q.
Still Leaking? Why Your Pelvic Floor is Failing & Medically-Approved Next Steps
A.
Persistent urine leaks often occur not just from weakness but from incorrect Kegels, a too-tight pelvic floor, overactive bladder, hormonal changes, prolapse, or nerve and medical conditions, and most leaks are treatable when the true cause is identified. Evidence-based next steps include supervised pelvic floor therapy, bladder training, lifestyle changes, and when needed medications, vaginal estrogen, pessaries, or procedures; there are several factors to consider, and the complete guidance below includes red flags and details that can affect which steps you should take.
References:
* pubmed.ncbi.nlm.nih.gov/36306516/
* pubmed.ncbi.nlm.nih.gov/30570777/
* pubmed.ncbi.nlm.nih.gov/37022883/
* pubmed.ncbi.nlm.nih.gov/31804374/
* pubmed.ncbi.nlm.nih.gov/35340807/
Q.
Always Need to Go? Why Frequent Urination Happens & Medical Next Steps
A.
Frequent urination is common and can be harmless or a sign of issues like a UTI, overactive bladder, diabetes, pregnancy, an enlarged prostate, stones, anxiety, or medication effects; most adults normally go about 6 to 8 times a day, so notable changes, urgency, burning, or waking often at night deserve attention. Next steps include tracking fluids and bathroom trips, cutting back caffeine and alcohol, trying timed voiding and pelvic floor exercises, and seeing a clinician if it persists, disrupts sleep, or you have pain, blood, fever, back pain, or sudden inability to urinate; there are several factors to consider, and the full list of causes, red flags, tests, and treatments is detailed below.
References:
* Spector, J. D., & Vella, A. (2018). Frequent urination (polyuria) in adults: etiology and evaluation. *Postgraduate Medicine*, *130*(3), 329-338. https://pubmed.ncbi.nlm.nih.gov/29528775/
* Griebling, T. L. (2018). Overactive bladder: a comprehensive review of diagnosis and management. *Translational Andrology and Urology*, *7*(Suppl 1), S48-S59. https://pubmed.ncbi.nlm.nih.gov/29675382/
* Weiss, J. P., & Drake, M. J. (2018). Nocturia: a review of causes, assessment, and treatment. *Nature Reviews Urology*, *15*(1), 23-34. https://pubmed.ncbi.nlm.nih.gov/29160533/
* Katsoulis, L. C., & D'Alessio, D. A. (2020). Clinical approach to polyuria. *Journal of the American Academy of Physician Assistants*, *33*(3), 19-25. https://pubmed.ncbi.nlm.nih.gov/32097368/
* Chapple, C. R., Gufeld, M., & Khullar, V. (2020). Management of overactive bladder: a comprehensive review of current clinical guidelines. *Translational Andrology and Urology*, *9*(Suppl 3), S340-S358. https://pubmed.ncbi.nlm.nih.gov/32775267/
Q.
Constantly Peeing? Why Your Body Triggers Polyuria + Medically Approved Next Steps
A.
Constantly peeing can be true polyuria, meaning more than 3 liters of urine in 24 hours, and common causes include high fluid intake, caffeine or alcohol, diabetes, diuretic medications, and less often kidney or hormonal problems, which is different from simply going often or overactive bladder. Medically approved next steps are to track 24 hour intake and urine amounts, cut back on bladder irritants, check blood sugar if at risk, review medications with your clinician, and seek urgent care for red flags like severe dehydration or confusion; there are several factors to consider, so see below for the complete list of causes, tests doctors use, and step by step guidance that could shape your next move.
References:
* Ruggiero V, Papi G, Scarlini L, Sforza A, Maggi P, Pignataro A, Caprio M. The Many Faces of Polyuria: A Review of Differential Diagnoses and Therapeutic Management. J Clin Med. 2022 Jan 10;11(2):315. doi: 10.3390/jcm11020315. PMID: 35056729; PMCID: PMC8778736.
* Christ-Crain M. Management of polyuria and polydipsia. Best Pract Res Clin Endocrinol Metab. 2020 Jul;34(4):101413. doi: 10.1016/j.beem.2020.101413. Epub 2020 May 6. PMID: 32371948.
* Weiss JP, Blute M, Van Kerrebroeck P. Pathophysiology and treatment of nocturnal polyuria. BJU Int. 2021 May;127(5):540-549. doi: 10.1111/bju.15277. Epub 2020 Dec 2. PMID: 33169389.
* Fenske WK, Christ-Crain M. Physiology and pathophysiology of polyuria. Nephrology (Carlton). 2019 Jul;24(7):727-732. doi: 10.1111/nep.13591. Epub 2019 Apr 23. PMID: 31221376.
* Tsuboi A, Sugimura T, Nishio S. Polyuria: Clinical Approach and Differential Diagnosis. Intern Med. 2018 May 15;57(10):1351-1355. doi: 10.2169/internalmedicine.0142-17. Epub 2018 Feb 21. PMID: 29775399; PMCID: PMC5999086.
Q.
Still Wetting the Bed? Why Enuresis Occurs & Medically Approved Next Steps
A.
Bedwetting, or enuresis, is common at all ages and usually stems from delayed bladder maturation, small bladder capacity, deep sleep, low nighttime ADH, genetics, constipation, or overactive bladder; secondary bedwetting or red flags like pain, blood in urine, daytime accidents, loud snoring with pauses, or excessive thirst should prompt a medical check. Medically approved steps include reassurance, smart evening fluids and regular daytime voiding, treating constipation, bedwetting alarms, and when needed medicines such as desmopressin, plus treatment of any underlying issues; there are several factors to consider, so see below to understand more and choose the right next steps.
References:
* Özdilek S, Şimşek F, Uçar T, Ünal D. Updates in the Management of Monosymptomatic Nocturnal Enuresis. Paediatr Drugs. 2023 Jul;25(4):393-404. doi: 10.1007/s40272-023-00569-8. Epub 2023 May 16. PMID: 37194883.
* Wang C, Li P, Hu X, Hu X, Sun H. Diagnosis and Management of Nocturnal Enuresis: A Narrative Review. Children (Basel). 2023 Nov 21;10(11):1854. doi: 10.3390/children10111854. PMID: 38002621; PMCID: PMC10670355.
* Rittig S. Physiological Mechanisms of Nocturnal Enuresis: A Narrative Review. J Clin Med. 2022 Jul 23;11(14):4288. doi: 10.3390/jcm11144288. PMID: 35887968; PMCID: PMC9322258.
* Lee HJ, Lee YS, Han SW, Kim SO, Paick JS, Chae HD. Non-pharmacological and pharmacological treatments for monosymptomatic nocturnal enuresis: A systematic review and meta-analysis. Medicine (Baltimore). 2021 Jun 25;100(25):e26322. doi: 10.1097/MD.0000000000026322. PMID: 34160472; PMCID: PMC8219013.
* Zingg S, Bauer M, Latal B, L'Hoste S, Hofer K, Landolt MA. Nocturnal Enuresis: Diagnostic and Therapeutic Procedures and Outcomes in 794 Children and Adolescents. J Clin Med. 2023 Mar 19;12(6):2394. doi: 10.3390/jcm12062394. PMID: 36983515; PMCID: PMC10053919.
Q.
Constant Urge? Why Your Bladder Is Overactive & Medically Approved Next Steps
A.
Overactive bladder is a common, treatable cause of constant urgency, frequency, and nighttime waking, and the medically approved next steps start with bladder training, pelvic floor exercises, and fluid changes, then medications, and, if needed, Botox or nerve stimulation. There are several factors to consider, including bladder irritants, pelvic floor weakness, aging, nerve disorders, diabetes or prostate issues. Know the red flags that need urgent care, like blood, pain or burning, fever, severe back or side pain, new leg weakness or numbness, or sudden inability to urinate, and see the complete guidance and next steps below.
References:
* Lightner DJ, Gomelsky A, Blavias JG, Fong E, Lemack GE, Nitti VW, Rovner ES, Vasavada SP. AUA/SUFU Guideline: Diagnosis and Treatment of Overactive Bladder (2019). J Urol. 2019 Sep;202(3):580-589. doi: 10.1097/JU.0000000000000392. PMID: 31201726.
* Sidorova A, Rahnama'i MS, Van Koeveringe GA. Pathophysiology of overactive bladder: a comprehensive review of the current theories. Int J Urol. 2021 Jul;28(7):697-707. doi: 10.1111/iju.14562. Epub 2021 Apr 22. PMID: 33887140.
* Nambiar AK, Chapple CR, van der Vaart CH, Hakimi Z, Brubaker L. Pharmacological treatment of overactive bladder syndrome: a systematic review and meta-analysis of effectiveness and tolerability. BJU Int. 2019 Jun;123(6):951-965. doi: 10.1111/bju.14605. Epub 2018 Dec 20. PMID: 30421448.
* Huang Y, Yang Y, Zhang Y, He M, Guo Y, Ma K, Li X, Liang S. Pelvic floor muscle training in women with overactive bladder: A systematic review and meta-analysis. Int Urogynecol J. 2020 Jan;31(1):21-34. doi: 10.1007/s00192-019-04144-8. Epub 2019 Nov 1. PMID: 31677054.
* Wein AJ, MacDiarmid S, Rovner ES. Current and Emerging Therapies for Overactive Bladder. Urol Clin. 2020 Feb;47(1):89-102. doi: 10.1016/j.ucl.2019.09.006. Epub 2019 Nov 15. PMID: 31735232.
Q.
Always Need to Pee? Why Your Bladder Is Overactive & Medical Next Steps
A.
The most common cause is overactive bladder, but UTIs, diabetes, prostate enlargement, pregnancy, medications, and drinking habits can also play a role; seek urgent care for blood in urine, fever with urinary symptoms, severe side or back pain, or sudden inability to pee. There are several factors to consider, so see below to understand more. Next steps include tracking a bladder diary, cutting back caffeine and evening fluids, trying bladder training and pelvic floor exercises, and seeing a clinician for testing and treatments including medications or, if needed, advanced options; full guidance is below.
References:
* Gürdal C, Üstüner E, Gürdal K. Overactive Bladder Syndrome: Current Perspectives. Turk J Urol. 2023 Mar;49(2):107-113. doi: 10.5152/tju.2023.23004. Epub 2023 Apr 6. PMID: 37021430; PMCID: PMC10129210.
* de Leve LAE, van der Aa HAR, de Leve AJL. Overactive Bladder: What's New? Curr Urol Rep. 2023 Nov 3;24(12):731-738. doi: 10.1007/s11934-023-01201-4. PMID: 37920786.
* Abrams P, Hashim H, Holm-Larsen T, Hunsballe JM, van der Velde R, Wessells H. Update on the diagnosis and management of overactive bladder. World J Urol. 2022 Nov;40(11):2713-2722. doi: 10.1007/s00345-022-05047-y. Epub 2022 Aug 26. PMID: 36029367; PMCID: PMC9603378.
* Grosse L, Griebling TL. Treatment of Overactive Bladder (OAB) in Older Adults: A Clinician's Perspective. Curr Urol Rep. 2021 Nov 22;22(12):747-753. doi: 10.1007/s11934-021-01103-z. PMID: 34686419.
* Tyagi S, Jain N, Garg SK. Current understanding of the pathophysiology of overactive bladder. Korean J Urol. 2020 May;61(5):295-305. doi: 10.4111/kju.2020.61.5.295. Epub 2020 May 27. PMID: 32462100; PMCID: PMC7267154.
Q.
Always Running? Why Your Bladder Is Overactive & Medically Approved Next Steps
A.
Overactive bladder is a treatable condition marked by sudden urgency, frequent urination, nighttime trips, and sometimes leakage, often driven by bladder muscle overactivity and factors like caffeine, hormonal changes, prostate enlargement, diabetes, or neurologic disease. There are several factors to consider for your specific situation; see below to understand more. Medically approved next steps start with bladder training, pelvic floor exercises, and fluid and constipation management, progress to medications such as anticholinergics or beta-3 agonists, and, if needed, advanced options like Botox or nerve stimulation, with urgent care warranted for blood in urine, pain, fever, severe back or abdominal pain, or sudden inability to urinate. Full details that could shape your personal plan are outlined below.
References:
* Ginsberg DA, et al. American Urological Association (AUA) and Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) Guideline for the Diagnosis and Treatment of Overactive Bladder (OAB) in Adults: 2019 Update. J Urol. 2019;202(6):1187-1193.
* Wang Y, et al. Overactive bladder: New understandings of pathophysiology, diagnosis, and treatment. Urol Sci. 2023;34(1):1-10.
* Chapple CR, et al. The management of overactive bladder: an updated consensus statement. Eur Urol. 2017;72(2):37-47.
* Nambiar A, et al. Oral pharmacotherapy for overactive bladder: an update. Ther Adv Urol. 2019;11:1756287219830218.
* Deng R, et al. Effectiveness of behavioral therapies in improving symptoms and quality of life in women with overactive bladder: A systematic review and meta-analysis. Neurourol Urodyn. 2023;42(4):645-662.
Q.
Frustrated by Leaks? Why Your Bladder is Always Active: Mirabegron & Medically Approved Next Steps
A.
Overactive bladder causes sudden urges, frequent trips, and leaks; mirabegron is a proven prescription that relaxes the bladder to increase storage and reduce urgency, often with fewer dry mouth and cognitive effects than older anticholinergic drugs. There are several factors to consider, including ruling out UTI, stones, or uncontrolled diabetes, starting bladder training and pelvic floor exercises, and knowing mirabegron can raise blood pressure and is not for severe uncontrolled hypertension. For stepwise treatment options, safety checks, and red flags like blood in urine or severe pain that need urgent care, see the complete guidance below.
References:
* Andersson, K. E., & Dmochowski, R. (2021). Pathophysiology and Treatment of Overactive Bladder. *International Urogynecology Journal*, 32(3), 595-608. PMID: 32986161.
* Al-Shaiji, T. F., & Al-Zoubi, A. (2023). The β3-Adrenergic Receptor Agonist Mirabegron for the Treatment of Overactive Bladder. *Journal of Clinical Medicine*, 12(7), 2683. PMID: 37049448.
* Newman, D. K., & Ezzelle, C. (2022). Diagnosis and Treatment of Overactive Bladder (OAB) in Women: A Comprehensive Review. *Journal of Women's Health (Larchmt)*, 31(5), 610-622. PMID: 35226154.
* Cuthbertson, K., et al. (2021). Mirabegron: A Review in Overactive Bladder. *Drugs*, 81(10), 1199-1210. PMID: 34156689.
* Chapple, C. R., et al. (2022). Emerging and Investigational Therapies for the Treatment of Overactive Bladder. *European Urology*, 81(4), 386-399. PMID: 35248443.
Q.
Is Myrbetriq Not Working? Why Your Bladder Is Spasming & Medically Approved Next Steps
A.
If Myrbetriq is not easing bladder spasms, common reasons include needing more time to reach full effect, often 4 to 8 weeks, being on too low a dose, other diagnoses like UTI or pelvic floor problems, and bladder irritants. Medically approved next steps include behavioral therapy, dose or medication changes including combination therapy, and advanced options like Botox or nerve stimulation, with urgent care for red flag symptoms when present; there are several factors to consider, so see the complete guidance below for details that could change your next steps.
References:
* Chapple CR, Staskin D, Hernandez C, Mitcheson D. Mirabegron in the Management of Overactive Bladder: A Review of Clinical Evidence and Patient Selection. Urologia Internationalis. 2017;99(3):257-271. doi:10.1159/000481878
* Tenenbaum S, Hameed T, Elterman D. Predictors of Mirabegron Treatment Failure in Patients with Overactive Bladder. International Braz J Urol. 2018 Jan-Feb;44(1):119-125. doi: 10.1590/S1677-5538.IBJU.2017.0270
* Gong Y, Tsui KF. Update on the Management of Refractory Overactive Bladder. Can Urol Assoc J. 2020 Jun;14(6):E277-E282. doi: 10.5489/cuaj.6423
* Elterman D, Hameed T, Tan S, et al. Third-line Therapies for Overactive Bladder: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Eur Urol Focus. 2022 Mar;8(2):464-474. doi: 10.1016/j.euf.2021.03.003
* Al-Hashimi M, Al-Hammouri N, Chapple CR. Guideline of Guidelines: Management of Overactive Bladder. Eur Urol Focus. 2021 Sep;7(5):989-992. doi: 10.1016/j.euf.2021.08.017
Q.
Still Leaking? Why Pelvic Floor Exercises Fail & Medical Next Steps
A.
There are several factors to consider. Leaking despite Kegels often means incorrect technique, a wrong diagnosis like overactive bladder, a pelvic floor that is tight not weak, too little time training, or nerve, prolapse, infection, or other medical issues. Next steps include pelvic floor physical therapy, bladder training, targeted medications, and, if needed, devices or procedures, plus lifestyle changes; watch for red flags like blood in urine or severe pain that require urgent care. See the complete guidance below for key details that can change which path you should take.
References:
* Bø K, Herbert RD. Pelvic floor muscle training in women with urinary incontinence and pelvic organ prolapse: mechanisms of action, clinical effects, and challenges. Int Urogynecol J. 2019 Feb;30(2):209-218. doi: 10.1007/s00192-018-3832-z. Epub 2019 Jan 3. PMID: 30606622.
* Dumoulin C, Cacciari LP, Fraser B. Pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev. 2018 Oct 23;10(10):CD001407. doi: 10.1002/14651858.CD001407.pub4. PMID: 30345752; PMCID: PMC6517036.
* Lukban JC, Jhang JF, Chen HY, et al. Management of female stress urinary incontinence: a clinical practice guideline. Taiwan J Obstet Gynecol. 2019 Nov;58(6):745-751. doi: 10.1016/j.tjog.2019.09.006. PMID: 31698226.
* Nager CW, Sirls LT. Management of stress urinary incontinence in women. JAMA. 2020 Nov 3;324(17):1786-1787. doi: 10.1001/jama.2020.17062. PMID: 33139049.
* Kim YJ, Kang SH. What Factors Influence the Success of Pelvic Floor Muscle Training for Female Urinary Incontinence? A Systematic Review. Int Neurourol J. 2018 Mar;22(1):3-11. doi: 10.5213/inj.1835054.269. Epub 2018 Mar 8. PMID: 29532506; PMCID: PMC5840679.
Q.
Always Going? Why Your Bladder Is Overactive: Gemtesa & Next Steps
A.
Frequent, urgent bathroom trips are often caused by overactive bladder, where the bladder squeezes too soon; Gemtesa (vibegron), a once daily beta 3 agonist, can relax the bladder to reduce urgency, frequency, and leaks. There are several factors to consider, including triggers, look-alike conditions to rule out, potential side effects and red flags, plus nondrug and advanced options with your doctor; see the complete details below to choose the safest, most effective next step.
References:
* pubmed.ncbi.nlm.nih.gov/32095995/
* pubmed.ncbi.nlm.nih.gov/36720188/
* pubmed.ncbi.nlm.nih.gov/37307986/
* pubmed.ncbi.nlm.nih.gov/36145695/
* pubmed.ncbi.nlm.nih.gov/36809800/
Q.
Bladder Leaks? Why Kegels Fail & Medically Approved Next Steps
A.
Kegel exercises often fail to stop bladder leaks when the problem is incorrect technique, a too-tight pelvic floor, overactive bladder, hormonal changes, or another underlying condition rather than true muscle weakness. Medically approved next steps include pelvic floor physical therapy, bladder training, lifestyle changes, medications, vaginal estrogen when appropriate, and devices or procedures for persistent cases, with urgent evaluation for red flags like blood in urine, severe pain, or new weakness. There are several factors to consider, so see the complete details below to understand more and choose the right next step with your clinician.
References:
* Šimunović M, Mikić D, Krivokapa I, Zadro K, Šimunović D. The role of pelvic floor muscle training for urinary incontinence. Acta Clin Croat. 2021 Sep;60(3):477-485. doi: 10.20471/acc.2021.60.03.17. PMID: 35027878; PMCID: PMC8744046.
* Abrams P, Dmochowski R, Wagg A, EAU-ICI Guideline Group. Diagnosis and Treatment of Female Urinary Incontinence: AUA/SUFU Guideline. J Urol. 2023 Feb;209(2):321-329. doi: 10.1097/JU.0000000000003058. PMID: 36724626.
* Bhatia N, Choo TH, Ranganathan S, Wager B, Cardenas-Turanzas M, Peden CJ, Siddiq S, Sunkara V, Yezhuvath R, Klinkner D, Singh H. Pharmacologic Treatment of Urinary Incontinence in Women: A Systematic Review. JAMA Intern Med. 2018 Jun 1;178(6):790-804. doi: 10.1001/jamainternmed.2018.1066. PMID: 29710330; PMCID: PMC6010065.
* Borges C, Furtado L, Pires PS, Zanetti MR, Silva LA, Haddad JM, Lima MVF. Predictors of failure of pelvic floor muscle training for stress urinary incontinence: a systematic review. Int Urogynecol J. 2022 Jul;33(7):1785-1798. doi: 10.1007/s00192-022-05183-1. Epub 2022 Apr 20. PMID: 35441999.
* Kwan B, Chou D, Power L, Kives S. Surgical management of stress urinary incontinence in women: A narrative review. Can Urol Assoc J. 2023 Mar;17(3):E84-E90. doi: 10.5489/cuaj.8242. PMID: 36877967; PMCID: PMC9983447.
Q.
Still Leaking? Why Oxybutynin Works + Medically Approved Next Steps
A.
Oxybutynin calms the bladder by blocking muscarinic receptors, cutting urgency, frequency, and urge leaks, with full benefit often taking 4 to 8 weeks. If you are still leaking, there are several factors to consider; see below for medically approved next steps like confirming adherence and dose optimization, addressing side effects and triggers, evaluating for stress or mixed incontinence, and considering pelvic floor therapy, alternative or combination medicines including beta-3 agonists, and procedures such as Botox or nerve stimulation, plus signs that warrant urgent care.
References:
* Dmochowski RR. Oxybutynin for the treatment of overactive bladder: a comprehensive review. Drug Des Devel Ther. 2018 Jan 29;12:283-294. Available from: pubmed.ncbi.nlm.nih.gov/29440810/
* Gormley EA, Lightner DJ, Faraday MM, Holloway TL, Krueger EA, Amundsen CL, Blander DS, Brown HW, Chu CM, Dmochowski RR. Management of Overactive Bladder (OAB) in Adults: AUA/SUFU Guideline (2019). J Urol. 2019 Jun;201(6):1098-1105. Available from: pubmed.ncbi.nlm.nih.gov/30747684/
* Chapple CR, Drake MJ. Current and emerging pharmacological treatments for overactive bladder. Ther Clin Risk Manag. 2017 Mar 9;13:285-298. Available from: pubmed.ncbi.nlm.nih.gov/28331398/
* Wu J, Yu H, Wang G, Zhang Y, Yu C, Song B. Behavioral therapies for overactive bladder: an evidence-based review. Curr Bladder Dysfunct Rep. 2018 Jun;13(2):162-171. Available from: pubmed.ncbi.nlm.nih.gov/29500690/
* Osaneme AA, Agrawal C, Smith AB. Treatment of Refractory Overactive Bladder: A Review of Current Options. Curr Bladder Dysfunct Rep. 2024 Jan 22:1-12. Available from: pubmed.ncbi.nlm.nih.gov/38250005/
Q.
Always Racing? Why Your Prostate Won’t Rest & Medically Approved Next Steps
A.
Urinary urgency, frequent nighttime trips, a weak or slow stream, and the feeling of incomplete emptying are most often caused by benign prostate enlargement, prostatitis, or overactive bladder, and less often prostate cancer; effective care ranges from lifestyle changes and medications to minimally invasive procedures or surgery. There are several factors to consider, including red flags like inability to urinate, fever with urinary symptoms, severe lower abdominal pain, or blood in urine that need urgent care; see below for the complete, medically approved next steps, what to expect at the doctor, and important details that could change your best course.
References:
* Gravas S. New insights into the pathophysiology of benign prostatic hyperplasia. Int Braz J Urol. 2021 Mar-Apr;47(2):191-201. doi: 10.1590/S1677-5538.IBJU.2020.0465. PMID: 33734674; PMCID: PMC8197793.
* Gratze P, Hruby S, Hitsch B, Hakenberg OW, Gakis G, Nagele U. Pharmacological treatment of benign prostatic hyperplasia: an update. World J Urol. 2020 Aug;38(8):1917-1929. doi: 10.1007/s00345-020-03099-3. Epub 2020 Feb 27. PMID: 32107567.
* Pontari MA. Recent advances in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome. Curr Urol Rep. 2019 May 15;20(7):35. doi: 10.1007/s11934-019-0902-1. PMID: 31093845.
* Zaccagnini M, Spatafora P, Tulli F, Pompili G, Fralleone A, Fumo F, Vianale G, Pastore AL, Fardella R, Pastore M, Cicerone P. The Role of Lifestyle in Preventing and Managing Benign Prostatic Hyperplasia. Clin Pract. 2023 Jul 19;13(4):758-771. doi: 10.3390/clinpract13040069. PMID: 37497746; PMCID: PMC10377041.
* Wang T, Long Z, Yan C, Wu G, Ma X. Molecular Mechanisms of Benign Prostatic Hyperplasia: A Focus on Aging and Inflammation. Cells. 2022 Mar 30;11(7):1178. doi: 10.3390/cells11071178. PMID: 35409476; PMCID: PMC9000100.
Q.
Nocturia Causes in Women 40-50: Medical Guide & Next Steps
A.
In women 40 to 50, waking to urinate two or more times nightly often stems from perimenopausal hormonal changes, overactive bladder, increased nighttime urine production, sleep disorders such as sleep apnea, UTIs, diabetes, medication effects, pelvic floor weakness, and rarely heart or kidney problems; there are several factors to consider, see below for what’s normal vs not and key red flags. Practical next steps include keeping a bladder diary, adjusting evening fluids and caffeine, elevating legs if swollen, pelvic floor exercises, trying an overactive bladder symptom check, and most importantly seeing a clinician for evaluation and testing if symptoms persist or are severe, with details and urgency guidance provided below.
References:
* Dmochowski RR, Kirk S, Corcos J. Nocturia: an under-recognized and undertreated symptom in perimenopausal women. Curr Urol Rep. 2019 Jun 27;20(8):41. doi: 10.1007/s11934-019-0906-8. PMID: 31250106.
* Kim YH, Lee KW, Kim YJ, Chung YS. Nocturia and menopause: a systematic review. Menopause. 2020 Jul;27(7):826-834. doi: 10.1097/GME.0000000000001550. PMID: 32371901.
* Dmochowski RR, Minhas S, O'Connor M. Nocturia in women: current understanding and management strategies. Nat Rev Urol. 2018 Jul;15(7):423-435. doi: 10.1038/s41585-018-0026-6. Epub 2018 May 25. PMID: 29805128.
* De Souza A, Wessels J, Akl MA, Patel N, Al-Nashash H, Al-Shamma S, Al-Dahhan T, O'Connor R, Sacco E. Lower urinary tract symptoms in perimenopausal women: a narrative review. World J Urol. 2022 Aug;40(8):1889-1897. doi: 10.1007/s00345-022-05047-w. Epub 2022 Jul 11. PMID: 35817814; PMCID: PMC9272306.
* Sacco E, Sforza C, Del Popolo G, D'Agostino D, Quattrini S, Pastore AL. Nocturia in women: an evaluation of the association with metabolic syndrome components. Clin Exp Obstet Gynecol. 2018;45(4):533-537. doi: 10.12891/ceog4250.2018. PMID: 30125049.
Q.
Nocturia Causes in Women 40-50: Medical Relief & Next Steps
A.
There are several factors to consider. In women 40 to 50, waking two or more times a night is often due to perimenopausal estrogen decline, overactive bladder, excess nighttime urine production, UTIs, pelvic floor weakness, sleep disorders like sleep apnea, or conditions such as diabetes or heart and kidney problems. Relief is usually possible with evening fluid and caffeine limits, leg elevation, sleep optimization, pelvic floor therapy, and targeted medicines including vaginal estrogen when appropriate, but seek prompt care for blood in urine, fever, severe swelling, intense thirst, or new symptoms after 50; see the complete guidance below for step by step next steps, symptom tracking, tests, and which specialist to see.
References:
* Ryu J, et al. The Association of Nocturia with Menopausal Symptoms in Midlife Women. Int Neurourol J. 2016 Mar;20(1):60-6. doi: 10.5213/inj.2016.20.1.60. Epub 2016 Mar 29. PMID: 27040409; PMCID: PMC4819777.
* Katz NT, et al. Nocturia in Women: Pathophysiology and Management. Curr Urol Rep. 2019 Jul 25;20(9):50. doi: 10.1007/s11934-019-0914-8. PMID: 31349548.
* Katz NT, et al. Diagnosis and treatment of nocturia in women. Curr Opin Urol. 2022 Jul 1;32(4):307-313. doi: 10.1097/MOU.0000000000000990. Epub 2022 May 26. PMID: 35760920.
* Dmochowski R, et al. Prevalence and bothersomeness of nocturia in women: An international, population-based survey. Neurourol Urodyn. 2018 Nov;37(8):2900-2910. doi: 10.1002/nau.23788. Epub 2018 Oct 26. PMID: 30368132; PMCID: PMC6901842.
* Yucel H, et al. Nocturia: A Narrative Review of Etiologies and Medical Management. J Clin Med. 2023 Jan 3;12(1):371. doi: 10.3390/jcm12010371. PMID: 36630043; PMCID: PMC9820524.
Q.
"I Can’t Stop Peeing": Finding Overactive Bladder Relief Without the "Zombie" Side Effects
A.
Overactive bladder relief without feeling like a zombie is achievable, starting with bladder training, pelvic floor therapy, and smarter hydration and diet, and extending to beta-3 agonist medications that ease urgency with less dry mouth and brain fog than older anticholinergics. There are several factors to consider, including ruling out lookalike conditions, managing side effects and blood pressure, and knowing when to escalate to bladder Botox or nerve stimulation; see below for red flag symptoms, a free symptom check, and practical steps to choose the right plan with your clinician.
References:
* Gades NM, et al. A review of mirabegron in the treatment of overactive bladder: focus on cognitive function and cardiovascular safety. Curr Med Res Opin. 2014 Oct;30(10):1995-2005. doi: 10.1185/03007995.2014.945281. Epub 2014 Aug 4. PMID: 25010996.
* Dmochowski RR, et al. Overactive bladder (OAB) and cognitive function: an update. Curr Urol Rep. 2014 May;15(5):409. doi: 10.1007/s11934-014-0409-7. PMID: 24652579.
* Nitti VW. New and emerging treatments for overactive bladder. Curr Opin Urol. 2015 Jul;25(4):287-93. doi: 10.1097/MOU.0000000000000185. PMID: 26049586.
* Cui Y, et al. OnabotulinumtoxinA in patients with overactive bladder and urge urinary incontinence refractory to oral therapy: a systematic review and meta-analysis. Int J Urol. 2021 Jan;28(1):3-12. doi: 10.1111/iju.14389. Epub 2020 Oct 21. PMID: 33083812.
* Min YS, et al. Current and Future Targets in Neuromodulation for Overactive Bladder. Int Neurourol J. 2019 Sep;23(3):189-198. doi: 10.5213/inj.1938072.308. Epub 2019 Sep 30. PMID: 31581735; PMCID: PMC6786835.
Q.
Gemtesa: 5 important things doctors want you to know
A.
Gemtesa (vibegron) treats overactive bladder by relaxing the bladder muscle, with improvements in urgency, leakage, and frequency often starting by 2 weeks and reaching full effect by 8 to 12 weeks. Doctors want you to know about common side effects like headache and mild GI upset, rare but urgent risks such as urinary retention or allergy, special caution in severe liver disease, blood pressure considerations and bladder outlet obstruction risk, and interactions or additive side effects with other OAB drugs; if you see no benefit by 12 weeks or develop trouble urinating, jaundice, or severe symptoms, seek care promptly. There are several factors to consider, and complete details are provided below to guide your next steps.
References:
Kamath PS, & Wiesner RH. (2001). A model to predict survival in patients with end-stage liver… Hepatology, 11157951.
European Association for the Study of the Liver. (2018). EASL Clinical Practice Guidelines for the management of patients with decompensated… Journal of Hepatology, 30187478.
Tsochatzis EA, Bosch J, & Burroughs AK. (2014). Liver cirrhosis: pathophysiology, clinical manifestations… Lancet, 24581650.
Q.
What is gemtesa used for?
A.
Gemtesa (vibegron) is a prescription medicine used to treat overactive bladder in adults, reducing sudden urinary urgency, frequent urination, leakage, and nighttime urination by relaxing the bladder muscle. There are several factors to consider, including who is a good candidate, how quickly it works, possible side effects, and safety considerations; see the complete details below to guide your next steps.
References:
Seki N, Hattori K, Takahashi S, Kishida S, Agawa T, Watanabe T. (2018). Efficacy and safety of vibegron, a β3-adrenoreceptor agonist… Int J Urol, 29182164.
Ripoll C, Groszmann RJ, Garcia-Tsao G, Bosch J, Grace ND, Burroughs AK, Planas R, Garcia-Pagán JC. (2007). Hepatic venous pressure gradient predicts development… Journal of Hepatology, 17848471.
Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. (2016). Portal hypertension and variceal bleeding: unresolved issues… Journal of Hepatology, 27393628.
Q.
What is gemtesa used for?
A.
Gemtesa is a prescription beta-3 adrenoceptor agonist used to treat overactive bladder in adults, reducing urinary urgency, frequency, nocturia, and urge incontinence by relaxing the bladder muscle. There are several factors to consider, including who is a good candidate, dosing, side effects, precautions, and interactions; see below for the complete answer and details that could shape your next steps.
References:
Nakashima S, Yamaguchi O, & Kadekawa K. (2019). Efficacy and safety of vibegron, a β3-adrenoceptor agonist, in patients with overactiv… Int J Urol, 31882239.
D'Amico G, Garcia-Tsao G, & Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhosis with ascites. Hepatology, 16521367.
European Association for the Study of the Liver. (2018). EASL Clinical Practice Guidelines on decompensated cirrhosis. J Hepatol, 30504103.
Q.
Are there any foods to avoid for overactive bladder (OAB)?
A.
For overactive bladder, it's helpful to avoid foods and drinks that can irritate the bladder, such as high-salt foods, caffeinated beverages, and acidic or spicy items.
References:
Leron E, Weintraub AY, Mastrolia SA, Schwarzman P. Overactive Bladder Syndrome: Evaluation and Management. Curr Urol. 2018 Mar;11(3):117-125. doi: 10.1159/000447205. Epub 2018 Feb 20. PMID: 29692690; PMCID: PMC5903463.
Matsuo T, Miyata Y, Otsubo A, Mukae Y, Mitsunari K, Ohba K, Sakai H. Efficacy of salt reduction for managing overactive bladder symptoms: a prospective study in patients with excessive daily salt intake. Sci Rep. 2021 Feb 18;11(1):4046. doi: 10.1038/s41598-021-83725-9. PMID: 33603133; PMCID: PMC7893030.
Park J, Lee H, Kim Y, Norton C, Woodward S, Lee S. Effectiveness of Fluid and Caffeine Modifications on Symptoms in Adults With Overactive Bladder: A Systematic Review. Int Neurourol J. 2023 Mar;27(1):23-35. doi: 10.5213/inj.2346014.007. Epub 2023 Mar 31. PMID: 37015722; PMCID: PMC10073005.
Q.
Are there any home remedies for overactive bladder (OAB)?
A.
Yes, several home remedies, including pelvic floor exercises, bladder training, and certain dietary changes, can help manage overactive bladder symptoms.
References:
Leron E, Weintraub AY, Mastrolia SA, Schwarzman P. Overactive Bladder Syndrome: Evaluation and Management. Curr Urol. 2018 Mar;11(3):117-125. doi: 10.1159/000447205. Epub 2018 Feb 20. PMID: 29692690; PMCID: PMC5903463.
Bo K, Fernandes ACNL, Duarte TB, Brito LGO, Ferreira CHJ. Is pelvic floor muscle training effective for symptoms of overactive bladder in women? A systematic review. Physiotherapy. 2020 Mar;106:65-76. doi: 10.1016/j.physio.2019.08.011. Epub 2019 Aug 24. PMID: 32026847.
Chen H, Hoi MPM, Lee SMY. Medicinal plants and natural products for treating overactive bladder. Chin Med. 2024 Mar 27;19(1):56. doi: 10.1186/s13020-024-00884-3. PMID: 38532487; PMCID: PMC10967063.
Q.
Does acupuncture work for curing overactive bladder (OAB)?
A.
Acupuncture may help reduce the symptoms of overactive bladder but it is not considered a cure.
References:
Zhao Y, Zhou J, Mo Q, Wang Y, Yu J, Liu Z. Acupuncture for adults with overactive bladder: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018 Feb;97(8):e9838. doi: 10.1097/MD.0000000000009838. PMID: 29465566; PMCID: PMC5841968.
Hargreaves E, Baker K, Barry G, Harding C, Zhang Y, Kandala NB, Zhang X, Kernohan A, Clarkson CE. Acupuncture for treating overactive bladder in adults. Cochrane Database Syst Rev. 2022 Sep 23;9(9):CD013519. doi: 10.1002/14651858.CD013519.pub2. PMID: 36148895; PMCID: PMC9502659.
Wang H, Lei X. Acupuncture for Women with Overactive Bladder: Perspective of Traditional Chinese Medicine and Related Mechanism. Int J Gen Med. 2023 Mar 28;16:1137-1148. doi: 10.2147/IJGM.S406194. PMID: 37013136; PMCID: PMC10066631.
Q.
How can I use a TENS machine for overactive bladder (OAB)?
A.
A TENS machine is used by placing small pads on your skin near the lower back or pelvic area to help ease overactive bladder symptoms by relaxing the nerves that control the bladder.
References:
Sharma N, Rekha K, Srinivasan KJ. Efficacy of Transcutaneous Electrical Nerve Stimulation in the Treatment of Overactive Bladder. J Clin Diagn Res. 2016 Oct;10(10):QC17-QC20. doi: 10.7860/JCDR/2016/21683.8729. Epub 2016 Oct 1. PMID: 27891403; PMCID: PMC5121741.
Bapir R, Bhatti KH, Eliwa A, García-Perdomo HA, Gherabi N, Hennessey D, Magri V, Mourmouris P, Ouattara A, Perletti G, Philipraj J, Stamatiou K, Trinchieri A, Buchholz N. Efficacy of overactive neurogenic bladder treatment: A systematic review of randomized controlled trials. Arch Ital Urol Androl. 2022 Dec 28;94(4):492-506. doi: 10.4081/aiua.2022.4.492. PMID: 36576454.
Q.
How long does overactive bladder (OAB) last?
A.
Overactive bladder is usually a long-term condition, and while treatments can help manage the symptoms, many people need ongoing care rather than a complete cure.
References:
Przydacz M, Campeau L, Walter JE, Corcos J. How long do we have to treat overactive bladder syndrome (OAB)? A questionnaire survey of Canadian urologists and gynecologists. Can Urol Assoc J. 2018 Sep;12(9):E378-E383. doi: 10.5489/cuaj.5032. PMID: 29787370; PMCID: PMC6143506.
Leron E, Weintraub AY, Mastrolia SA, Schwarzman P. Overactive Bladder Syndrome: Evaluation and Management. Curr Urol. 2018 Mar;11(3):117-125. doi: 10.1159/000447205. Epub 2018 Feb 20. PMID: 29692690; PMCID: PMC5903463.
Q.
Is there any surgery for overactive bladder (OAB)?
A.
Surgery for overactive bladder is not usually the first choice, but there are options available for patients whose symptoms do not improve with other treatments.
References:
Vasdev N, Biles BD, Sandher R, Hasan TS. The surgical management of the refractory overactive bladder. Indian J Urol. 2010 Apr;26(2):263-9. doi: 10.4103/0970-1591.65402. PMID: 20877607; PMCID: PMC2938553.
Trowbridge ER, Hoover EF. Evaluation and Treatment of Urinary Incontinence in Women. Gastroenterol Clin North Am. 2022 Mar;51(1):157-175. doi: 10.1016/j.gtc.2021.10.010. Epub 2022 Jan 7. PMID: 35135660.
Q.
What is double voiding for OAB?
A.
Double voiding is a technique where you urinate, wait a little, and then try to go again to help empty your bladder completely.
References:
**Cambridge University Hospitals NHS Foundation Trust.** Bladder Care and Management. _Cambridge University Hospitals_.
https://www.cuh.nhs.uk/patient-information/bladder-care-and-management/
Q.
What is the best over the counter medicine for overactive bladder (OAB)?
A.
There isn’t one best over-the-counter medicine for overactive bladder, but research suggests that pumpkin seed oil may help improve urinary symptoms.
References:
Nishimura M, Ohkawara T, Sato H, Takeda H, Nishihira J. Pumpkin Seed Oil Extracted From Cucurbita maxima Improves Urinary Disorder in Human Overactive Bladder. J Tradit Complement Med. 2014 Jan;4(1):72-4. doi: 10.4103/2225-4110.124355. PMID: 24872936; PMCID: PMC4032845.
Vozmediano-Chicharro R, Madurga B, Blasco P. Efficacy of Transdermal Oxybutynin in the Treatment of Overactive Bladder Syndrome: Does It Make Sense Using It in 2017? Adv Urol. 2018 Jul 29;2018:6782736. doi: 10.1155/2018/6782736. PMID: 30151004; PMCID: PMC6087608.
Williams G, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2023 Apr 17;4(4):CD001321. doi: 10.1002/14651858.CD001321.pub6. Update in: Cochrane Database Syst Rev. 2023 Nov 10;11:CD001321. doi: 10.1002/14651858.CD001321.pub7. PMID: 37068952; PMCID: PMC10108827.
Q.
What is the difference between overactive bladder (OAB) in men and women?
A.
Overactive bladder (OAB) symptoms can be similar to lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH), but OAB is a separate condition that affects both men and women differently.
References:
Eapen RS, Radomski SB. Gender differences in overactive bladder. Can J Urol. 2016 Feb;23(Suppl 1):2-9. PMID: 26924589.
Herrewegh, A. G. M., Vrijens, D. M. J., Marcelissen, T. A. T., & van Koeveringe, G. A. (2019). Bladder sensations in male and female overactive bladder patients compared to healthy volunteers: a sensation-related bladder diary evaluation. _Scandinavian Journal of Urology_, _53_(4), 255–260. https://doi.org/10.1080/21681805.2019.1641551
Pautz A, Michel MC. Sex and Gender Differences in the Pharmacology of the Overactive Urinary Bladder. Handb Exp Pharmacol. 2023;282:57-74. doi: 10.1007/164_2023_667. PMID: 37439844.
Q.
What is the main cause of overactive bladder (OAB)?
A.
The main cause of overactive bladder is the bladder muscle, called the detrusor, contracting too much when the bladder fills up, which creates an urge to urinate suddenly.
References:
White N, Iglesia CB. Overactive Bladder. Obstet Gynecol Clin North Am. 2016 Mar;43(1):59-68. doi: 10.1016/j.ogc.2015.10.002. PMID: 26880508.
Carpenter L, Campain NJ. Overactive bladder: not just a normal part of getting older. Br J Nurs. 2022 Oct 13;31(18):S16-S22. doi: 10.12968/bjon.2022.31.18.S16. PMID: 36227795.
Zheng Y, Cameron AP. Sleep and Overactive Bladder in Parkinson's Disease. Urol Clin North Am. 2024 May;51(2):197-207. doi: 10.1016/j.ucl.2024.02.005. Epub 2024 Mar 10. PMID: 38609192.
Q.
What kind of diet is recommended for overactive bladder (OAB)?
A.
A diet for overactive bladder should include reducing salt, caffeine, and bladder irritants, along with a focus on balanced, healthy eating.
References:
Robinson D, Giarenis I, Cardozo L. You are what you eat: the impact of diet on overactive bladder and lower urinary tract symptoms. Maturitas. 2014 Sep;79(1):8-13. doi: 10.1016/j.maturitas.2014.06.009. Epub 2014 Jun 17. PMID: 25033724.
Willis-Gray MG, Dieter AA, Geller EJ. Evaluation and management of overactive bladder: strategies for optimizing care. Res Rep Urol. 2016 Jul 27;8:113-22. doi: 10.2147/RRU.S93636. PMID: 27556018; PMCID: PMC4968994.
Matsuo T, Miyata Y, Otsubo A, Mukae Y, Mitsunari K, Ohba K, Sakai H. Efficacy of salt reduction for managing overactive bladder symptoms: a prospective study in patients with excessive daily salt intake. Sci Rep. 2021 Feb 18;11(1):4046. doi: 10.1038/s41598-021-83725-9. PMID: 33603133; PMCID: PMC7893030.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1White N, Iglesia CB. Overactive Bladder. Obstet Gynecol Clin North Am. 2016 Mar;43(1):59-68. doi: 10.1016/j.ogc.2015.10.002. PMID: 26880508.
https://www.sciencedirect.com/science/article/abs/pii/S0889854515001072?via%3DihubRobinson D, Cardozo L. Managing overactive bladder. Climacteric. 2019 Jun;22(3):250-256. doi: 10.1080/13697137.2018.1552254. PMID: 31034265.
https://www.tandfonline.com/doi/full/10.1080/13697137.2018.1552254?cookieSet=1Chen LC, Kuo HC. Pathophysiology of refractory overactive bladder. Low Urin Tract Symptoms. 2019 Sep;11(4):177-181. doi: 10.1111/luts.12262. Epub 2019 Mar 22. PMID: 30900373.
https://onlinelibrary.wiley.com/doi/10.1111/luts.12262Peyronnet B, Mironska E, Chapple C, Cardozo L, Oelke M, Dmochowski R, Amarenco G, Gamé X, Kirby R, Van Der Aa F, Cornu JN. A Comprehensive Review of Overactive Bladder Pathophysiology: On the Way to Tailored Treatment. Eur Urol. 2019 Jun;75(6):988-1000. doi: 10.1016/j.eururo.2019.02.038. Epub 2019 Mar 26. PMID: 30922690.
https://www.sciencedirect.com/science/article/abs/pii/S0302283819301861?via%3DihubRaju R, Linder BJ. Evaluation and Treatment of Overactive Bladder in Women. Mayo Clin Proc. 2020 Feb;95(2):370-377. doi: 10.1016/j.mayocp.2019.11.024. PMID: 32029089.
https://www.mayoclinicproceedings.org/article/S0025-6196(19)31039-0/fulltext