Condition
Overactive Bladder
OAB causes urgent, frequent urination and sometimes leakage. Treatment options range from behavioral therapy to advanced procedures.
Common symptoms
- Strong sudden urges
- Frequency (8+ times in 24 hours)
- Nocturia (waking to urinate)
Overactive bladder (OAB) means urinary urgency, often with frequency and sometimes incontinence. It is not a disease itself but a constellation of symptoms — and one of the most disruptive conditions we treat. Patients often plan their day around bathroom access. We can change that.
How we evaluate
A focused history, bladder diary, urinalysis, and post-void residual measurement usually tell us what we need to know. In complex cases — especially when initial treatments have not worked — we use urodynamics to characterize bladder behavior precisely.
A treatment ladder
- Behavioral changes: timed voiding, fluid management, caffeine reduction
- Pelvic floor physical therapy
- Oral medications (anticholinergics, beta-3 agonists)
- Bladder Botox — in-office, lasts 6–9 months
- InterStim sacral neuromodulation — durable, often life-changing
When to escalate
If two oral medications have not given you adequate relief, it is time to consider Botox or InterStim. Both are FDA-approved, well-studied, and reversible. Many patients wish they had escalated sooner.