About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Causes
By Mayo Clinic staff
Normal bladder function
Filling and emptying your bladder is a complex interplay of kidney function, nerve signals and muscle activity. A problem anywhere in this system can contribute to overactive bladder and urge incontinence.
It all starts with your kidneys, which produce urine. Urine leaves the kidneys and travels down a pair of long tubes to your bladder. Urine drains from your bladder through an opening at the bottom (neck) and flows out a short tube called the urethra (u-REE-thrah). In women, the urethral opening is located just above the vagina. In men, the urethral opening is at the tip of the penis.
Your bladder expands like a balloon to accommodate urine from the kidneys. When it's reached about a third of its capacity, nerve signals alert your brain, and you sense that your bladder is starting to fill. As it fills more, you'll feel the need to urinate (void). When you urinate, nerve signals coordinate the relaxation of the pelvic floor muscles and the muscles surrounding the neck of the bladder and upper portion of the urethra (urinary sphincter muscles). The muscles of the bladder contract, forcing urine out.
Involuntary bladder contractions
The symptoms of overactive bladder occur in most cases because the muscles of the bladder involuntarily contract. This contraction creates the urgent need to urinate. However, in some people, this urge is purely sensory, meaning that you might feel the need to void even though the muscles aren't contracting.
Several factors may cause or contribute to signs and symptoms similar to those of overactive bladder. Your doctor may try to rule them out during an evaluation because they require other specialized treatments. These factors include:
- Neurological disorders, such as Parkinson's disease, strokes and multiple sclerosis, are often associated with an overactive bladder.
- High urine production as might occur with high fluid intake, poor kidney function or diabetes
- Acute urinary tract infections that can cause symptoms very similar to an overactive bladder
- Abnormalities in the bladder, such as tumors or bladder stones
- Factors that obstruct bladder outflow — enlarged prostate, constipation or previous operations to treat other forms of incontinence
- Excess consumption of caffeine or alcohol
- Medications that cause a rapid increase in urine production or require that you take them with lots of fluids
In some cases, doctors can't identify the specific cause of your overactive bladder.
- Cartwright R, et al. Current management of overactive bladder. Current Opinion in Obstetrics and Gynecology. 2008;20:489.
- Carr RJ. Urinary incontinence. In: South-Paul JE, et al. Current Diagnosis and Treatment in Family Medicine. 2nd ed. New York, N.Y.: McGraw Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=3036304. Accessed Aug. 2, 2010.
- Tanagho EA, et al. Urinary incontinence. In: Tanagho EA, et al. Smith's General Urology. 17th ed. New York, N.Y.: McGraw Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=3129492. Accessed Aug. 2, 2010.
- Overactive bladder. American Urological Association. http://www.urologyhealth.org/adult/index.cfm?cat=03&topic=450. Accessed Aug. 2, 2010.
- What I need to know about Bladder Control for Women. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/bcw_ez/. Accessed Aug. 2, 2010.
- Ellsworth PI, et al. Frequently asked questions in the evaluation and management of overactive bladder. Journal of Family Practice. 2009;58supp:1.
- Hartmann KE, et al. Treatment of overactive bladder in women. Agency for Healthcare Research and Quality. http://www.ahrq.gov/downloads/pub/evidence/pdf/bladder/bladder.pdf. Accessed Aug. 2, 2010.
- DuBeau CE. Clinical presentation and diagnosis of urinary incontinence. http://www.uptodate.com/home/index.html. Accessed Aug. 2, 2010.
- Urodynamic testing. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/urodynamic/. Accessed Aug. 2, 2010.
- DuBeau CE. Treatment of urinary incontinence. http://www.uptodate.com/home/index.html. Accessed Aug. 2, 2010.
- Anger JT, et al. Outcomes of intravesical botulinum toxin for idiopathic overactive bladder symptoms: A systematic review of the literature. The Journal of Urology. 2010;183:2258.
- Lightner DJ (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 4, 2010.
- Subak LL, et al. Weight loss to treat urinary incontinence in overweight and obese women. New England Journal of Medicine. 2009;360:481.
Find Mayo Clinic on