Urinary Incontinence

Overactive Bladder

Overactive Bladder

Clear guidance on overactive bladder, explaining urinary urgency, frequency, and urge incontinence, along with behavioral strategies, medications, bladder Botox injections, and sacral neuromodulation for persistent symptoms.

Written and reviewed by Shervin Badkhshan, MD · Last reviewed

November 2026

Part of:

Leakage and bladder control

In-Office Clinic Care

Immediate Recovery

Fellowship-Trained Reconstructive Urology

AT-A-GLANCE CLINICAL CARE PATHWAY

Symptom-to-Solution Overview

1. COMMON SYMPTOMS

• Sudden uncontrollable urinary urgency • Frequent daytime & nighttime urination • Urgency leakage before reaching toilet

2. IN-OFFICE WORKUP

• Urinalysis & infection exclusion • Uroflowmetry & post-void residual check • Multi-channel urodynamic evaluation

Explore Diagnostic Test Guides →

3. TREATMENT OPTIONS

• Targeted bladder pharmacology • In-office intravesical Botox injections • InterStim sacral neuromodulation therapy

Browse Surgical Procedures →

Overactive Bladder (OAB) is a common clinical syndrome characterized by a sudden, involuntary contraction of the bladder muscle. Normally, your bladder fills smoothly and signals you when it is full. With OAB, the bladder muscle spasms or signals an emergency long before it is actually full. This creates a persistent, highly disruptive pattern of urgency that can severely interrupt sleep cycles, work routines, and daily activities.

Primary Symptoms

  • Sudden Urgency: An unexpected, intense, and compelling need to urinate immediately that is incredibly difficult to delay.

  • Frequent Urination: Needing to empty your bladder abnormally often, typically more than 8 times within a 24-hour period.

  • Nocturia: Waking up two or more times during the night specifically to urinate, deeply disrupting sleep quality.

  • Urge Leakage: Involuntary loss of urine immediately following a sudden spike in urgency.

Diagnostic Approach

  1. Bladder Diary Log: Tracking fluid intake, frequency of urination, and episodes of leakage over a 3-day period to reveal behavioral and functional baselines.

  2. Urinalysis: Checking a clean urine sample to rule out active infections or microscopic blood that could mimic bladder hyperactivity.

  3. Post-Void Residual Ultrasound: A quick scan to confirm that your bladder is emptying completely and that your frequency isn't caused by trapped urine.

Recommended Surgical & Treatment Pathways

Dedicated Subspecialty Center: BPH & Advanced Voiding Therapies Hub →

Surgical Reconstruction: Aquablation Therapy — Autonomous robotic waterjet resection alleviating obstruction-induced detrusor overactivity.

Surgical Reconstruction: Transurethral Resection of the Prostate (TURP) — Endoscopic bipolar plasma resection unroofing prostatic channels.

Surgical Reconstruction: Robotic Simple Prostatectomy — Minimally invasive enucleation for severe large-gland BPH.

Diagnostic Imaging & Labs: Kidney, Bladder & Prostate Ultrasound Results →

Diagnostic Imaging & Labs: Urinalysis & Urine Culture Results Explained →

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Your results and questions

Your actual test results, visit notes, and messages with your care team are in your patient portal, the same one you use to book visits. Send questions through the portal or call the office at (516) 535-1900. For anything urgent, call the office or go to the nearest emergency room.