Overactive bladder treatment in Salt Lake City
Overactive bladder is a sudden, hard-to-ignore urge to urinate, often with frequent bathroom trips, waking at night, and sometimes leaking before you reach the toilet. It's common in women and men, and it's treatable. Elisabeth Ferlic, MD, is a board-certified urologist in the Salt Lake Valley with fellowship training in voiding dysfunction and female pelvic medicine. Overactive bladder treatment in her practice starts with the least invasive step and moves forward only if you need more.
Elisabeth Ferlic, MD
Board-certified urologist · Fellowship-trained in voiding dysfunction and female pelvic medicine
In this guide
- Overactive bladder symptoms
- What is overactive bladder?
- Why see Dr. Ferlic for overactive bladder
- What are my options?
- Overactive bladder treatment options
- Causes and risk factors
- How overactive bladder is diagnosed
- What to expect
- Managing overactive bladder day to day
- Benefits and risks, side by side
- What happens at the first visit?
- Overactive bladder FAQs
Overactive bladder symptoms
Urgency is the symptom that defines the condition. The others often come with it:
Urgency and leaking
- Urgencya sudden, strong need to urinate that you can't ignore or delay for long
- Urge incontinenceleaking on the way to the bathroom, from a few drops to a full loss of control
How often you go
- Frequencyurinating eight or more times in 24 hours
- Waking at night (nocturia)getting up two or more times a night to urinate
Many people adapt without noticing. They find the restroom before they sit down, drink less before a drive, or skip a movie or a hike. If your bladder sets your schedule, that alone is reason enough to get evaluated.
When to be seen promptly. Pain is not a defining symptom of overactive bladder. Burning or pain with urination often points to a urinary tract infection, and blood in your urine always needs an evaluation. Symptoms that start suddenly, especially with heavy leaking, can signal an infection or a nerve problem. Contact a doctor for any of these.
What is overactive bladder?
Overactive bladder, often shortened to OAB, is a group of symptoms, not a single disease. A healthy bladder fills quietly and signals you when it's close to full. With an overactive bladder, the bladder muscle squeezes, or the nerves send a "urgent" message, before the bladder is full. The urge arrives without warning and is hard to put off.
It's far more common than most people assume. The Urology Care Foundation reports that as many as 40 percent of women and 30 percent of men have these symptoms. Overactive bladder becomes more common with age, but it isn't a normal part of aging; nothing you did caused it.
Overactive bladder is different from stress incontinence, which is leaking with a cough, a sneeze, or a lift. Many people have both. The urinary incontinence page covers stress and mixed leaking.
Why see Dr. Ferlic for overactive bladder
Many people with overactive bladder have had the same experience: a short visit, a prescription, and no conversation about what comes next if it doesn't work. Dr. Ferlic is a board-certified urologist and fellowship-trained in voiding dysfunction and female pelvic medicine. That fellowship is advanced training in how the bladder stores and empties urine, in women and in men.
Because of that training, one physician can take you through every step on the path. That includes the advanced therapies many clinics refer elsewhere, and care for the nerve-related bladder conditions that can look like overactive bladder. Visits last as long as the problem requires, and you leave knowing what each option involves. Read more about Dr. Ferlic, or see how overactive bladder fits into women's pelvic health and men's urology.
What are my options?
A starting point for the conversation, not a prescription. Your evaluation decides what fits.
Urgency and frequent trips
Your bladder sets your schedule
Bladder retraining and daily habits
Urinate on a schedule, then lengthen the time between trips
Urges that are hard to quiet
In women and in men
Pelvic floor therapy
Quick squeezes to quiet an urge, with about six weeks of practice
Urgency and frequency after menopause
Lower estrogen thins the tissue of the urethra and bladder
Vaginal estrogen
Can ease urgency and frequency, alongside any other step
Earlier steps haven't given enough relief
Or medication side effects outweigh the benefit
Bladder Botox or nerve stimulation
Relax the bladder muscle, or steady the nerve signals to the bladder
Overactive bladder treatment options
Overactive bladder treatment can combine several approaches. Behavioral treatment and pelvic floor therapy are common starting points, and some people need no further treatment. You can combine steps to fit your situation. Medication is one step on the path, with other steps before it and more options after it.
| Bladder Botox | Sacral nerve stimulation | Tibial nerve stimulation (PTNS) | |
|---|---|---|---|
| Where it works | The bladder wall | The nerve signals between the bladder and the brain | A nerve near the ankle that is linked to the bladder |
| How it works | Small doses placed through a thin scope relax the muscle | A small implanted device, similar to a pacemaker, steadies the signals | A thin needle delivers mild pulses |
| Schedule | The effect lasts about six months on average, and the treatment can be repeated | A temporary trial comes first; the device is placed only if the trial helps | Weekly 30-minute sessions for 12 weeks |
Bladder Botox
- Where it works
- The bladder wall
- How it works
- Small doses placed through a thin scope relax the muscle
- Schedule
- The effect lasts about six months on average, and the treatment can be repeated
Sacral nerve stimulation
- Where it works
- The nerve signals between the bladder and the brain
- How it works
- A small implanted device, similar to a pacemaker, steadies the signals
- Schedule
- A temporary trial comes first; the device is placed only if the trial helps
Tibial nerve stimulation (PTNS)
- Where it works
- A nerve near the ankle that is linked to the bladder
- How it works
- A thin needle delivers mild pulses
- Schedule
- Weekly 30-minute sessions for 12 weeks
Bladder retraining and daily habits
Bladder retraining teaches the bladder to hold more and to signal later. You urinate on a schedule instead of at every urge, then lengthen the time between trips by about 15 minutes at a time. Most people need six to eight weeks to see the full effect.
Daily habits matter too. Cutting back on caffeine, alcohol, and carbonated drinks helps many people. So does treating constipation, because a full bowel presses on the bladder.
Pelvic floor therapy
A pelvic floor physical therapist teaches you to find, strengthen, and relax the muscles that support the bladder, and to use quick squeezes to quiet an urge. It works for women and men. Expect about six weeks of regular practice before you notice a change. Dr. Ferlic refers patients to pelvic floor therapy often, and for some people it is the only treatment they need.
Medication, for some people
Prescription medications that relax the bladder muscle help some people, usually alongside the first two steps. They also have limits. One older group commonly causes dry mouth and constipation, and long-term use has raised concerns about memory and confusion. A second group avoids those effects but calls for a blood pressure check in some patients. Dr. Ferlic tells you what a medication is likely to help and when a prescription that isn't working needs to stop.
For women after menopause, vaginal estrogen can ease urgency and frequency, and it fits alongside any other step. See hormone and menopause care.
Advanced therapies
If the earlier steps haven't given you enough relief, or the side effects of medication outweigh the benefit, three established therapies remain.
- Bladder Botox. Small doses of Botox placed in the bladder wall through a thin scope relax the muscle. The effect lasts about six months on average, and the treatment can be repeated. Read more about bladder Botox.
- Sacral nerve stimulation (Axonics or InterStim). A small implanted device, similar to a pacemaker, steadies the nerve signals between the bladder and the brain. A temporary trial comes first, and the device is placed only if the trial helps.
- Tibial nerve stimulation (PTNS). A thin needle near the ankle delivers mild pulses to a nerve linked to the bladder, in weekly 30-minute sessions for 12 weeks. See sacral and tibial nerve stimulation for both nerve treatments.
Major surgery for overactive bladder is rare and reserved for severe cases that nothing else has helped.
Ask about an appointment or call 435-344-4760 to talk through where you are on this path.
Causes and risk factors
The bladder and the brain communicate through nerves. Overactive bladder happens when those signals misfire or the bladder muscle contracts when it isn't supposed to. Often no single cause is found. When there is one, it usually falls into one of these groups:
- Nerve conditions. Stroke, multiple sclerosis, Parkinson's disease, spinal problems, and long-standing diabetes can disrupt bladder signals. When a nerve condition drives the symptoms, the diagnosis is neurogenic bladder, and the treatment plan changes.
- Menopause. Lower estrogen thins the tissue of the urethra and bladder, which can bring on urgency and frequency.
- Prostate enlargement. A prostate that blocks the flow of urine makes the bladder work harder. See enlarged prostate (BPH).
- Pelvic floor changes. Pregnancy, childbirth, and pelvic surgery can weaken the muscles that support the bladder.
- Irritants and other contributors. Caffeine, alcohol, water pills, urinary tract infections, constipation, extra body weight, and a bladder that doesn't empty completely can each cause or worsen symptoms.
Sorting out which of these applies to you is why a diagnosis comes before any prescription.
How overactive bladder is diagnosed
Most of the diagnosis comes from a careful conversation. Dr. Ferlic reviews your symptoms, your medical history, the medications you take, and what you drink during the day. From there, the evaluation usually includes:
- A physical exam, which can include a pelvic exam for women and a prostate exam for men
- A urine test to check for infection or blood
- A bladder scan, a quick ultrasound that shows whether your bladder empties completely
- A bladder diary, kept for about three days, that records what you drink, how often you urinate, and when you leak
For most people, that's enough to start treatment. More detailed testing, such as cystoscopy, is reserved for symptoms that don't fit the usual pattern and for cases where earlier treatment hasn't worked.
What to expect
Improvement with overactive bladder is gradual. Behavioral steps and pelvic floor therapy take regular practice over weeks. Follow-up timing depends on your treatment and symptoms. If a step is working, you keep going. If it isn't, you and Dr. Ferlic decide together whether to adjust it, add to it, or move to the next one.
Overactive bladder is usually a condition you manage rather than cure; symptoms can return if the habits or the treatment stop. With the right plan, most people improve: fewer trips, more warning, better sleep, and less planning around bathrooms.
A history and bladder diary can be discussed by video. Ask whether a virtual visit fits your symptoms and whether urine testing or an examination is needed first.
Managing overactive bladder day to day
These habits can help manage symptoms alongside treatment:
- Drink steadily, not sparingly. Too little fluid concentrates the urine, which irritates the bladder. Spread fluids through the day and taper off two to three hours before bed if nighttime trips are the problem.
- Find your triggers. Coffee, tea, alcohol, soda, citrus, tomato-based foods, chocolate, and spicy foods bother some bladders and not others. Remove them, then add them back one at a time.
- Keep your bowels regular. Fiber, fluids, and daily movement prevent constipation.
- Stay at a healthy weight and don't smoke. Extra weight presses on the bladder, and tobacco irritates the bladder muscle.
- Keep up the pelvic floor exercises. The benefit lasts only as long as the practice does.
Pads and protective underwear are useful during treatment, but they manage leaks and don't treat the cause. If you've relied on them for years, an evaluation is worth your time.
Benefits and risks, side by side
Every treatment has trade-offs. Your history and your goals decide which ones matter most.
What treatment can address
- A sudden urge that's hard to put off
- Frequent trips during the day
- Waking at night to urinate
- Leaking before you reach the toilet
What to weigh first
- Overactive bladder is usually managed rather than cured
- Behavioral steps and therapy take weeks of regular practice
- Medications have side effects, and some call for a blood pressure check
- A nerve condition, menopause, or the prostate can change the plan
What happens at the first visit?
The visit starts with what has changed and what you want help with. Any treatment and follow-up plan is specific to you.
Talk through your symptoms
Bring your concerns, medication list, and relevant medical history.
Decide what needs checking
Testing depends on your symptoms and history, and some concerns need a separate workup.
Discuss a plan and follow-up
Review benefits, risks, alternatives, and what to watch for.
Before you schedule
Ask which appointments are available and whether your concern suits a video visit or needs an in-person evaluation.
Here’s what our great patients say
Can overactive bladder be cured?
A complete cure is uncommon, but lasting control is a realistic goal. Most people who follow a treatment plan see a clear improvement in urgency, frequency, and leaking, and many are satisfied with the result. Symptoms can change over time. An evaluation helps identify other causes and a plan that fits your needs.
Do I have to take medication for overactive bladder?
No. Medication is one option among several, and it isn't the first step. Bladder retraining, changes to what you drink, and pelvic floor therapy are common starting points. Treatment choices depend on your symptoms, preferences, and medical history. If medication hasn't worked for you, or the side effects weren't worth it, bladder Botox and nerve stimulation are established next steps.
Will drinking less water help?
Usually not. Cutting fluids too far makes urine more concentrated, and concentrated urine irritates the bladder and can increase urgency. Drinking far more than you need can make symptoms worse too. A better plan is to drink a steady, moderate amount through the day, limit caffeine and alcohol, and taper off in the evening.
How do I calm my bladder when the urge hits?
Stop, stay still, and don't rush to the bathroom, because hurrying makes the bladder contract harder. Squeeze and release your pelvic floor muscles promptly several times, take a slow breath, and wait for the urge to fade. Then walk to the bathroom at a normal pace. A pelvic floor therapist can teach you this technique.
Is overactive bladder the same as incontinence?
They overlap, but they aren't the same. Overactive bladder is defined by urgency, and many people with it never leak. When urgency does cause leaking, it is called urge incontinence. Leaking with a cough, sneeze, or exercise is stress incontinence, which has different causes and different treatments, and some people have both.
Do men get overactive bladder?
Yes. Millions of men have it, and it is often mistaken for a prostate problem. Sometimes an enlarged prostate is the cause, sometimes the bladder itself is, and sometimes both play a part. History, examination, and selected tests help distinguish a prostate blockage from a bladder problem.
Talk with a urologist about overactive bladder
If urgency, frequent trips, or nighttime waking are shaping your days, ask about an evaluation. Call 435-344-4760 or request an appointment. You can also read about second opinions and records review if you already have a diagnosis or treatment plan.
This page is for general education and is not medical advice.