To pee or not to pee? Find help to control an overactive bladder

You’re in a crowded store and suddenly you need to pee. Right now! You panic. You know where the bathroom is (because you always make a point to know where the nearest bathroom is), but will you make it there in time?

Overactive bladder is a common and complex medical condition. Symptoms often come without warning and the rush to find a bathroom can leave you feeling frustrated and embarrassed. You may even start to avoid social invitations out of fear of having an accident. 

Incontinence and an increased urge to urinate can be made worse by medical conditions like a urinary tract or bladder infection, diabetes, stroke or multiple sclerosis (MS). It can also be made worse by some medications (diuretics), and food or drinks that may irritate your bladder, such as caffeinated beverages (coffee, soda and tea) and spicy foods.

For 90 percent of women, there is no known cause for an overactive bladder. However, you may be able to ease your urge to pee through simple lifestyle and dietary changes. My recommendations usually starts with simple lifestyle changes. For example:

• Cut back on how much water and other caffeinated beverages you drink. Not everyone needs to drink eight glasses of water (64 ounces) a day. Drink when you’re thirsty.
• If you get up several times a night to pee, stop drinking fluids about three hours before bedtime.
• During the day, schedule regular bathroom breaks, up to seven to eight a day, to get there before a sudden urge occurs.
• Strengthen your pelvic floor muscles through exercise.

What if I’ve already tried these things and they don’t help?

• Talk with your doctor or see a specialist.
• I may refer you to a physical therapist who is specially trained in pelvic floor rehabilitation.
• I may prescribe oral medications with or without pelvic floor physical therapy.
• If oral medication doesn’t work for you or is for some reason is not a good option for you, I may offer Botox injections into the bladder, which can calm down your bladder irritation and reduce your symptoms. Botox injections can be done during an office visit and the calming effects usually last between 6-12 months. When symptoms return, the process can be repeated.
• I may also recommend use of an implantable electronic device which acts like a pacemaker for your bladder, or nerve stimulation, which acts like an acupuncture treatment for your bladder.

Whatever your overactive bladder symptoms, the good news is that help is available. If you have symptoms of overactive bladder or incontinence, don't just live with it, talk with your doctor. We will be able to determine the cause, and then help you find the best treatment for you.