The primary symptom of overactive bladder (OAB) is urinary urgency, a sudden overwhelming need to pee. It’s often accompanied by the need to go much more frequently than usual, including waking up to pee one or more times at night. For some sufferers, in what is known as “wet OAB,” there can also be urinary incontinence, resulting in leakage or accidents.

These symptoms can have far-reaching effects on the quality of life for OAB sufferers. “Recreation, going to the movies, getting together with people in groups, sleeping well,” says Dr. Sender Herschorn of the Division of Urology for the University of Toronto at Sunnybrook Health Sciences Centre. “It makes all these things harder.”

The result is often a powerful feeling of isolation and shame. It’s a condition that can be difficult to talk about, and which leads to social withdrawal. The anxiety that OAB causes can in turn lead to further problems, both psychological and physical. “People who have overactive bladder have higher levels of depression,” Says Dr. Herschorn. “They have more time off work. And they have other chronic illnesses. Overall they are a sicker group of patients.”


Dr. Sender Herschorn
Professor of Surgery/Urology, University of Toronto, Attending Urologist, Sunnybrook Health Sciences Centre

Seeking help for those who suffer

When you are living life hostage to your own bladder, things which otherwise might be quite simple can suddenly become daunting. It’s next to impossible to enjoy a social outing when you need to always be aware of where the nearest bathroom is, and can never be sure you will be able to make it on time when the urgency strikes.

The condition affects both men and women but, for men particularly, it can be very difficult to acknowledge the condition and seek treatment. “Anywhere from 25 percent to 50 percent of sufferers either don’t seek treatment or have abandoned treatment,” says Dr. Herschorn.

“Men have more hesitation in coming forward. There are barriers to acknowledging that they have lower urinary tract symptoms. And a lot of people think it’s just a normal process of aging and nothing can be done, so they just suffer in silence or they cover it up.”

"... the medications are very safe, even for men with enlarging prostates.”

Suffering in silence however, is not a solution. The good news is that, for those who overcome this reluctance and do seek treatment, there are solutions that can be extremely effective. In many cases, OAB in men is correlated with otherwise benign prostate enlargement.

Prostate drugs can often be very successful in reducing the symptoms of OAB, either alone or in combination with other medications. “The medications work quite well,” says Dr. Herschorn. “What’s also been shown through many randomized trials is that the medications are very safe, even for men with enlarging prostates.”

Medication and lifestyle changes together can free you

Importantly, changes in behaviour and lifestyle can also have a pronounced effect. “We educate patients, and they need to buy into this, about overhydrating themselves, drinking caffeinated beverages, drinking fluids in the evening. We also teach them, even men, to do pelvic floor exercises. If you combine this behaviour modification with the medications, it works better than either alone.”

One thing that the research has clearly shown though is that, when the patient does buy into the treatment, through medication and through lifestyle changes, the results can be dramatic. With such effective treatments available, it is so important that all sufferers of overactive bladder empower themselves to talk to their doctors. The potential for improving your quality of life simply by speaking up is profound.