What overactive bladder is
Overactive bladder (OAB) is a sudden, strong urge to urinate that is hard to put off. It often comes with frequent trips to the bathroom during the day, waking up at night to urinate, and sometimes leaking before you reach the bathroom (urge incontinence). OAB is common in both women and men. It is not a normal part of aging that you have to accept, and treatment helps most people.
Common symptoms
- A sudden urge to urinate that is hard to delay
- Urinating more often than usual during the day
- Waking up at night to urinate
- Leaking urine with the urge (urge incontinence)
Leaking with coughing, sneezing or exercise is a different problem called stress incontinence. Many people have both. See urinary incontinence treatment for stress and mixed leakage.
The evaluation
Dr. Neal Patel, a board-certified urologist, starts with your history and a bladder diary, a urine test to rule out infection or blood, and a check of how well your bladder empties. In men, the prostate is also evaluated, because an enlarged prostate can cause similar symptoms. Some people need further testing such as urodynamics or cystoscopy.
A step-by-step approach to treatment
- Bladder habits and lifestyle. Bladder training, timed voiding, adjusting fluids, caffeine and alcohol, managing constipation and pelvic floor muscle exercises, often with a pelvic floor physical therapist.
- OAB medications. Two main types of medicine calm the bladder muscle. Dr. Neal Patel helps choose one that fits your other health conditions and weighs side effects such as dry mouth and constipation, and in older adults, possible effects on memory with some medicines.
- Bladder Botox. Botulinum toxin is injected into the bladder wall through a thin scope to relax an overactive bladder muscle. The effect wears off over months, so injections are repeated. A small number of people have temporary trouble emptying the bladder and may need to use a catheter for a while.
- Tibial nerve stimulation. Gentle stimulation of a nerve near the ankle, with weekly office sessions or a small implant. See tibial nerve stimulation.
- InterStim sacral neuromodulation. A small implanted device that sends mild pulses to the sacral nerves that help control the bladder, after a trial to see whether it helps. See InterStim sacral neuromodulation.
Dr. Neal Patel personally provides OAB medications, bladder Botox, tibial nerve stimulation and InterStim, so your plan can move to the next step without starting over with a new doctor. You and Dr. Patel decide together which option fits your symptoms, health and preferences.
Recognized for advanced OAB care
Advanced Urology is recognized as a Medtronic World Center of Excellence on Advanced Overactive Bladder Therapies. Medtronic makes the InterStim system. Advanced Urology Centers of Excellence.
Next step
Call 678-344-8900 or book online with Advanced Urology. Dr. Neal Patel sees women and men with overactive bladder in Johns Creek and Cumming.
Frequently asked questions
How many times a day is normal to urinate? Many adults urinate about every three to four hours while awake. Going much more often, or waking more than once a night to urinate, can be a sign of overactive bladder and is worth discussing.
Is overactive bladder the same as incontinence? Not exactly. Overactive bladder is the sudden urge to urinate and frequent urination. Some people with OAB also leak with the urge, which is called urge incontinence, while others do not leak at all.
What if OAB medicines did not work or caused side effects? There are effective options beyond pills, including bladder Botox injections, tibial nerve stimulation and InterStim sacral neuromodulation.
How long does bladder Botox last? The effect wears off over several months, and the injections are repeated when symptoms return. Your follow-up schedule is planned with you.
Can men have overactive bladder? Yes. In men, an enlarged prostate can cause similar symptoms, so the prostate is checked as part of the evaluation.
Where Dr. Neal Patel sees patients
Dr. Neal Patel sees patients from across metro Atlanta at two Advanced Urology offices:
- Johns Creek: 10730 Medlock Bridge Rd, Ste 110, Johns Creek, GA 30097
- Cumming: 4150 Deputy Bill Cantrell Memorial Rd, Ste 180, Cumming, GA 30040
His Advanced Urology team also sees patients in Decatur and Braselton. Call 678-344-8900 to book. Same-day and next-day appointments are often available.
Preparing for your visit with Dr. Neal Patel
Bring a list of your current medications and supplements, any prior urine, blood or PSA results, and the reports (or discs) from recent imaging. If you can, arrive with a comfortably full bladder, because a urine sample and a bladder scan are often part of the first visit. Write down your main questions so nothing is missed. A family member is welcome to join you. If you prefer Spanish or Korean, let the office know when you book so language support is ready.
Your chart is reviewed before you arrive, and insurance requirements for likely imaging or procedures are checked up front so approvals can move sooner. Before you leave, your orders, prescriptions and follow-up plan are reviewed with you, and you receive education materials tailored to your condition.
At the end of the visit you will receive a written summary in your preferred language that explains what was found, what was ordered and what happens next. Your primary care physician or referring doctor receives a clear update letter with findings, plan and next steps, so everyone caring for you stays informed. Dr. Neal Patel sees patients at the Johns Creek and Cumming offices; call 678-344-8900.
Reviewed by Dr. Neal Patel, MD, board-certified urologist. This page is general information and not a substitute for medical advice.