Overactive Bladder

Overactive bladder (OAB) is a cluster of symptoms — sudden urgent need to urinate, frequent urination, and often leakage before reaching the toilet. It is common — especially in older women — and under-reported in India due to embarrassment. It is not a normal part of ageing and is usually treatable.

Typical symptoms

• Urgency — sudden strong urge to pass urine, hard to defer.
• Frequency — urinating more than 8 times in 24 hours.
• Nocturia — waking more than once at night to urinate.
• Urge incontinence — leaking urine before reaching the toilet.
• Often coexists with stress incontinence (leak on cough/laugh/sneeze) — "mixed incontinence".

Rule out other causes first

• Urinary tract infection.
• Diabetes — both directly (high sugar) and via nerve effects.
• Enlarged prostate (in men).
• Neurological — multiple sclerosis, stroke, Parkinson's, spinal cord problems.
• Pelvic organ prolapse, post-menopausal vaginal atrophy (in women).
• Medicines — diuretics ("water tablets"), caffeine, alcohol, some antidepressants.
• Bladder stones or tumour in persistent or blood-tinged cases.

What helps

• Bladder training — scheduled voiding with gradually longer intervals; keeps you in control instead of the bladder.
• Pelvic-floor (Kegel) exercises — helpful for both urge and stress incontinence.
• Lifestyle: reduce caffeine and alcohol; don't over-drink water "to flush"; manage weight; treat constipation; stop smoking.
• Medicines — anticholinergic class or beta-3 agonist class; short-term trials are reasonable under a doctor. Common side effect: dry mouth, constipation.
• Vaginal estrogen for postmenopausal women.
• Intravesical botulinum toxin injection and sacral neuromodulation — for refractory cases at urology centres.
• Absorbent pads are a reasonable temporary aid — not a permanent solution; they are commonly used because the condition goes untreated.

See a doctor

• Any new urgency / incontinence — it's treatable; don't accept it as "normal ageing".
• Blood in urine, pain, or fever — rule out infection or tumour.
• Men with poor stream, dribble, or nocturia — check prostate.
• Fall risk due to nocturia in older adults — a fixable problem that also prevents fractures.