Management of Overactive Bladder

Behavioral Interventions

Behavioral interventions are the first choice in helping manage an overactive bladder. They're often effective, and they carry no side effects. Life style modifications may include:

  • Healthy weight. If you're overweight, losing weight may ease symptoms. Weight loss may help if you also have stress urinary incontinence.
  • Scheduled toilet trips. Setting a schedule for toileting — for example, every two to four hours — gets you on track to urinate at the same times every day rather than waiting until you feel the urge to urinate.
  • Bladder training. Bladder training involves training yourself to delay voiding when you feel an urge to urinate. You begin with small delays, such as 30 minutes, and gradually work your way up to urinating every three to four hours. Bladder training is possible only if you're able to tighten (contract) your pelvic floor muscles successfully.
  • Certain foods and drinks can make your symptoms worse if you already have an overactive bladder. Try to avoid these—or better yet, eliminate them: Spicy foods, such as those containing hot peppers or curry Citrus fruits and juices, such as orange, tangerine, and grapefruit Tomatoes/tomato products, including spaghetti sauce and tomato paste; chocolate Coffee and tea, both caffeinated and decaffeinated; Alcoholic beverages Beverages that contain artificial sweeteners like aspartame. Diet Pepsi, Mountain Dew or Coke then would be especially problematic because of the artificial sweetener and the caffeine

Bladder Medications

Medicines for bladder control general work by blocking signals that may cause muscle spasms in the bladder muscles.


Brand Name

Generic Name

Detrol LA®

Tolterodine extended release form

Ditropan XL®

Oxybutynin chloride
Oxybutynin extended-release form
Oxybutynin patch delivery system


Oxybutynin chloride 10% gel


Oxybutynin chloride 3% gel

Enablex ®


Sanctura XR® 

Trospium chloride
Trospium chloride extended-release form


Solifenacin succinate


Fesoterodine fumarate



Common side effects of most of these drugs include dry eyes and dry mouth, but drinking water to quench thirst can aggravate symptoms of overactive bladder. Constipation can aggravate your bladder symptoms.

Other Therapies

Injections for bladder. Although Botox has long been used to smooth aging skin, new research finds that the muscle relaxant is also a useful treatment an overactive bladder. Botox is the brand name for botulinum. Injection of botulinum toxin may have beneficial effects in patients with medication refractory detrusor overactivity and may offer a new minimally invasive alternative to patients with severe overactive bladder symptoms. Botox can be given either when asleep ('general anaestheisa') or with the bladder made numb ('local anaesthesia'). An endoscope examination of the bladder is performed ('cystoscopy'). Botox has a good, long-lasting, safe and consistent effect over time among patients who do initially respond well to it and choose to continue treatment.

Nerve stimulation. The sacral nerve stimulation (SNS) involves the use of a device that can be thought of as a pacemaker for the bladder. InterStim Therapy is a sacral nerve stimulation therapy and has been used successfully to treat thousands of patients worldwide. At home, the patient can control the level of stimulation and turn the SNS system “on” and “of” with the patient programmer. The programmer is a hand-held device and is about the size of a cell phone.