Urology · University Urology, PC · Knoxville, TN
Overactive Bladder & Urinary Urgency
Overactive bladder (OAB) is one of the most common urologic conditions — and one of the most undertreated. Effective options exist from simple behavioral changes to minimally invasive procedures. You do not have to live with urgency, frequency, or leakage.
About OAB
What Is Overactive Bladder?
Overactive bladder is a syndrome characterized by a sudden, urgent need to urinate that is difficult to control, often with urinary frequency (urinating 8 or more times per day) and nocturia (waking at night to urinate). It may or may not involve urgency urinary incontinence (leakage with the urge to go).
Common Symptoms
Sudden strong urge to urinate · Urinating more than 8 times in 24 hours · Waking more than once at night to urinate · Leaking urine before reaching the bathroom
Who Is Affected
OAB affects approximately 1 in 6 adults. It becomes more common with age and is present in both men and women. Many patients live with symptoms for years before seeking treatment.
Treatment Options
Effective Treatments for OAB
Behavioral Therapy
Bladder training, timed voiding, fluid management, and pelvic floor exercises are first-line treatments with significant evidence of effectiveness — no medication required.
Medications
Antimuscarinics and beta-3 agonists (Myrbetriq, Vibegron) relax the bladder muscle. Multiple options exist if one medication is not tolerated.
Bladder Botox
Botulinum toxin injected directly into the bladder muscle. Effective for 6–9 months per treatment. Performed in-office in 15 minutes. See our Botox preparation page.
Sacral Neuromodulation (Axonics)
A small implantable device that modulates the nerve signals controlling the bladder. Long-term solution for patients who have not responded to medications or Botox. Starts with an in-office trial. See our PNE trial preparation page.
Urodynamic Evaluation
A functional test of bladder behavior that identifies the specific type and cause of voiding dysfunction, guiding treatment selection. See our UDS preparation page.
PTNS (Percutaneous Tibial Nerve Stimulation)
Minimally invasive nerve stimulation therapy delivered through the ankle. Office-based, no implant required. An alternative to sacral neuromodulation for appropriate patients.
Common Questions
Frequently Asked Questions
Is OAB just a normal part of aging?
OAB becomes more common with age, but it is not an inevitable or untreatable condition. Effective treatments exist at every stage and most patients experience significant improvement with appropriate management.
I tried a medication and it didn’t help. Are there other options?
Yes. Multiple medication classes exist, and if oral medications fail or are not tolerated, bladder Botox and sacral neuromodulation (Axonics implant) are both highly effective and durable options. Many patients who were told they had no more options find significant relief with these treatments.
How do I know if I need urodynamics?
Urodynamics is recommended when the diagnosis is unclear, when initial treatments have failed, or when surgical or procedural treatment is being planned. Your provider will discuss whether a UDS is indicated at your visit.
Urgency and Frequency Don\'t Have to Be Your Normal.
Effective OAB treatment is available. Our team evaluates and treats the full spectrum of bladder dysfunction across 11 East Tennessee locations.