Overactive Bladder Treatment Everyday Health MenuNewslettersSearch Incontinence Overactive Bladder TreatmentDrugs, surgery, and medical devices can all be used to treat overactive bladder. By Quinn PhillipsMedically Reviewed by Sophia Delpe Goodridge, MDReviewed: July 22, 2022Medically ReviewedMedication and Botox are common ways to treat an overactive bladder.iStock; Getty Images Overactive bladder (OAB) can significantly harm your quality of life by interrupting your daily activities and your sleep with the urgent need to urinate. Once your doctor has confirmed a diagnosis of overactive bladder, the two of you can plan a course of treatment together. Often, this treatment plan begins with lifestyle changes that can help your bladder act more predictably. But if lifestyle measures aren’t enough to get your overactive bladder under control, your doctor may recommend physical therapy and bladder training — and it may be time to add medical or surgical treatments. Since overactive bladder is a set of symptoms rather than a disease with specific causes, there isn’t a single treatment protocol for doctors to follow. Instead, your doctor will recommend a course of treatment that takes into account your specific symptoms, as well as any known medical conditions that are contributing to your overactive bladder. The goal of treatment for overactive bladder is to improve your quality of life by reducing the severity or frequency of your urges to urinate, as well as addressing any anxiety or social concerns associated with these urges or urine leakage (incontinence). Apart from lifestyle changes, physical therapy, and bladder training, the main treatments for overactive bladder are drugs, nonsurgical treatments, implantable devices, and surgery. (1,2) Medication to Relax the Bladder Once you and your doctor conclude that lifestyle measures (and possibly physical therapy and bladder training) aren’t adequately controlling your overactive bladder, drugs are often the first treatment to be added. You may continue with behavioral changes when drugs are added to your treatment plan, or you may give up certain lifestyle changes if they’ve become too difficult to maintain. Most of the drugs used to treat overactive bladder work by relaxing your bladder muscle. They help prevent your bladder from contracting (squeezing) before it’s full of urine. Some drugs for overactive bladder are taken by mouth, while others are given as a gel that you apply or a patch that you wear on your skin. It may take some time to figure out what dose of a drug works best for you. Always follow your doctor’s instructions about dosing, including whether and when to change the dose you’re taking. If a drug doesn’t work well enough even after you arrive at an optimal dose, your doctor may recommend that you add another drug or switch to taking a different one. (1) The following drugs may be prescribed for overactive bladder:tolterodine (Detrol)oxybutynin (Ditropan, Gelnique, Oxytrol skin patch)trospium (Sanctura)solifenacin (Vesicare)vibegron (Gemtesa)mirabegron (Myrbetriq)fesoterodine (Toviaz)propantheline (Pro-Banthine)dicyclomine (Bentyl, Dibent) (2,3) Nonsurgical Treatments and Implantable Devices If your overactive bladder isn’t well controlled using lifestyle changes and prescription drugs, your doctor may refer you to a specialist if you aren’t seeing one already. A specialist, usually a urologist, will be able to offer certain nonsurgical procedures and implantable devices to help ease your symptoms. Botox injections Botox (botulinum toxin) is a paralytic agent with a number of medical uses. To treat overactive bladder, it’s injected into your bladder muscle. (Other toxins also can be used to treat overactive bladder.) Botox treatment can help prevent your bladder from contracting (squeezing) too easily or often. But it may also relax your bladder so much that it doesn’t fully empty, especially during the period shortly after you receive the treatment. Urinary retention affects about 9 percent of people who receive Botox treatment for overactive bladder, according to the Mayo Clinic. (2) If this happens to you, you may need to use a catheter (a small, flexible tube) intermittently to fully empty your bladder until it’s able to do so on its own. The effects of Botox treatment eventually wear off. For overactive bladder, treatments tend to be effective for about five months or longer. (1,2) Neuromodulation therapy Also known as nerve stimulation, this type of treatment uses electrical impulses to change how nerves in certain areas of your body work. There are two main types of neuromodulation therapy for overactive bladder:Sacral neuromodulation (SNS)Percutaneous tibial nerve stimulation (PTNS) Sacral neuromodulation involves surgically implanting a thin wire, called a neurotransmitter, near the sacral nerves at the base of your spine. These nerves connect your bladder to your spinal cord. The neurotransmitter is then tested using an external device to generate electrical impulses. If the treatment is confirmed to be working well for you, your doctor will perform a second procedure in which a battery-powered pulse generator is placed under your skin. Percutaneous tibial nerve stimulation, on the other hand, requires no surgical implantation. It’s usually done weekly during an office visit, for 12 weeks. In this procedure, your doctor places a needle electrode near your ankle, which sends electrical impulses to your tibial nerve. This nerve runs up your leg to your sacral nerves. If this treatment appears to help control your symptoms, you’ll receive monthly maintenance therapy after the first 12 weekly sessions. (1,2,3) Surgery Is a Last Resort for Restoring Proper Bladder Function If lifestyle measures, drug treatments, Botox, and neuromodulation therapy are all ineffective at relieving your symptoms, your doctor may consider more drastic surgical treatments for overactive bladder. These surgical treatments are usually reserved for people with severe symptoms. At this point, two main surgical options are available: Surgery to Increase Bladder Capacity Surgically increasing the size of your bladder may help relieve pressure and improve its ability to store urine. In this procedure, your doctor removes pieces of your bowel and uses them to replace a portion of your bladder. If you have this surgery, you may need to use a catheter intermittently to urinate for the rest of your life. Bladder Removal As a last resort, your doctor may remove your bladder. A replacement bladder, called a neobladder, may be surgically constructed, or your urine may be routed to the outside of your body through a hole in your skin called a stoma. If you have a stoma following this surgery, you’ll wear a bag or pouch on your skin to collect your urine. (2) Resources We LoveAmerican Urological AssociationNational Association for ContinenceNational Association for Continence BHealth BlogAmerican Urogynecologic Society (AUGS)Urology Health ExtraRestore My ControlHarvard HealthIncontinence SourceSuzanne Andrews: 30 Day Bladder Fix: Pelvic Floor StrengtheningNHS.ukMayo ClinicNEWSLETTERS Sign up for our Healthy Living Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. Editorial Sources and Fact-Checking Overactive Bladder (OAB). Urology Care Foundation.Overactive Bladder. Mayo Clinic. May 3, 2022.Overactive Bladder. Cleveland Clinic. 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