Overactive bladder (OAB) is a common condition where there is a frequent feeling of needing to urinate to a degree that it negatively affects a person's life.

[1] Diagnosis is based on a person's signs and symptoms and requires other problems such as urinary tract infections or neurological conditions to be excluded.

[1] If treatment is desired pelvic floor exercises, bladder training, and other behavioral methods are initially recommended.

[1] Urgency is currently defined by the International Continence Society (ICS), as of 2002, as "Sudden, compelling desire to pass urine that is difficult to defer."

[1] The number of episodes varies depending on sleep, fluid intake, medications, and up to seven is considered normal if consistent with the other factors.

[citation needed] Nocturia is a symptom where the person complains of interrupted sleep because of an urge to void and, like the urinary frequency component, is affected by similar lifestyle and medical factors.

Individual waking events are not considered abnormal, one study in Finland established two or more voids per night as affecting quality of life.

[17] It is also possible that the increased contractile nature originates from within the urothelium and lamina propria, and abnormal contractions in this tissue could stimulate dysfunction in the detrusor or whole bladder.

OAB causes similar symptoms to some other conditions such as urinary tract infection (UTI), bladder cancer, and benign prostatic hyperplasia (BPH).

Urinary tract infections often involve pain and hematuria (blood in the urine) which are typically absent in OAB.

[25] The distinction is not absolute; one study suggested that many classified as "dry" were actually "wet" and that people with no history of any leakage may have had other syndromes.

Patients who continue to experience incontinence episodes, or who express a desire for medication along with therapy, may be treated with several classes of drugs, notably anticholinergics.

Patients who prove resistant to medications and therapy may then be treated with neurological interventions, such as treatment with botulinum toxin (Botox) and other minimally-invasive surgical procedures, such as sacral neuromodulation.

These include bladder training, which involves scheduled voiding (urination) and gradually increasing the time between bathroom visits.

However, numerous studies have demonstrated that these therapies are effective in improving quality of life, and some data shows that they increase the likelihood that medications can keep the OAB under control.

A number of antimuscarinic drugs (e.g., darifenacin, hyoscyamine, oxybutynin, tolterodine, solifenacin, trospium, fesoterodine) are frequently used to treat overactive bladder.

[32] Patients taking oxybutynin and other anticholinergic drugs experience a 70% reduction of incontinence episode frequency, on average.

[33] Botulinum toxin A (Botox) is approved by the Food and Drug Administration in adults with neurological conditions, including multiple sclerosis and spinal cord injury.

[35][36] The growing knowledge of pathophysiology of overactive bladder fueled a huge amount of basic and clinical research in this field of pharmacotherapy.

[40] One surgical intervention, called a cystoplasty, involves the enlargement of the bladder using tissue taken from the patient's ileum, which is part of the small intestine.

[41] Because overactive bladder is most commonly associated with aging, the majority of patients experience symptoms (with or without incontinence) for the rest of their lives.

However, a recent Finnish population-based survey[44] suggested that the number of people affected had been largely overestimated due to methodological shortcomings regarding age distribution and low participation (in earlier reports).