Bathroom Blues: An Overactive Bladder Can Be Very Demanding

Nobody should know the location of every bathroom in western North Carolina, but some do. Opening the door or simply driving into the garage can trigger an uncontrollable urge to urinate. Learn how to reclaim your life from some leading urology experts.

What is overactive bladder?

According to Brian Cohen, MD, urologist with Mission Urology, overactive bladder plagues people about seven years before they seek care. The condition is known by its symptoms of frequent urination or a sudden urge to urinate and not being able to get there.

What causes it? A myth about overactive bladder is that it’s a natural part of aging. “While we don’t know why it starts, symptoms often increase with stress or the anxiety associated with a potential leakage, furthering negative voiding patterns,” said Nancy Howden, MD, urogynecologist with Western Carolina Women’s Specialty Center, an affiliate of Mission Health. It almost becomes a habit.

How are people affected?

“It can be incredibly limiting,” said James Theofrastous, MD, urogynecologist with Western Carolina Women’s Specialty Center, an affiliate of Mission Health. People stop going to church or supper with friends. Some who fear or are embarrassed by accidents suffer from isolation, depression and anxiety. Intimacy can be difficult, skin becomes irritated from being wet and it’s very costly. Some patients even fall or get hurt rushing to the bathroom, said Dr. Theofrastous.

Who is at risk?

“Everyone with a bladder is at risk,” said Dr. Theofrastous. More women than men have the condition, with about 50 to 70 percent of postmenopausal women affected. While it occurs more in older people, it’s not a normal part of aging.

What should you do?

Dr. Cohen urges patients to first talk with their doctor, who can prescribe medications, refer them to a pelvic floor physical therapist for urge control and help them make other lifestyle changes.

How is it treated?

“One of the first things I suggest is a voiding schedule to reestablish healthy patterns of every 2-3 hours,” said Dr. Howden. A food and bladder diary provides insight into triggers such as caffeine or alcohol so patients can make better lifestyle choices. “Pelvic floor physical therapy should be a cornerstone of all treatment,” said Dr. Howden. Other options include medicine, Botox in the bladder and procedural interventions such as neuromodulation.

While overactive bladder is common, it does not have to be part of getting older. There are many options to help you regain control.


Brian Cohen, MD, is a urologist with Mission Urology.

Nancy Howden, MD, is a urogynecologist with Western Carolina Women’s Specialty Center, an affiliate of Mission Health.

James Theofrastous, MD, is a urogynecologist with Western Carolina Women’s Specialty Center, an affiliate of Mission Health.

For more information about our urology and urogynecology services, call Mission Urology at 828-254-8883 or Western Carolina Women’s Specialty Center, an affiliate of Mission Health, at 828-670-5665. Visit missionhealth.org/urology [1].