Bladder Control Issues

Bladder control issues are caused by the layered, smooth muscle that surrounds the bladder contracting spastically. This results in sustained, high bladder pressure and urgent need to urinate.

Millions of people suffer from bladder control problems. Their symptoms include urinary frequency, urinary urgency, nighttime urination, urinary incontinence, low urinary stream and incomplete bladder emptying. The treatment of these symptoms depends on the underlying cause and may be different for each patient.

We specialize in women's pelvic health, including the diagnosis and treatment of all types of bladder control problems and symptoms. Our team of urologists, urogynecologists and physician assistants will carefully gather your history, and with the help of specialized tests, determine a diagnosis and treatment plan designed specifically for you.

Overactive bladder is caused by the layered, smooth muscle that surrounds the bladder contracting spastically, sometimes without known cause, which results in sustained, high bladder pressure and urgent need to urinate. Normally, the muscle around the bladder contracts and relaxes in response to the volume of urine in the bladder and the initiation of urination. Learn more from »

Risk Factors

Underlying chronic infections of the urinary tract such as chronic cystitis, prostatitis, and/or urethritis Obstructive diseases such as Benign Prostatic Hypertrophy and urethral strictures Underlying neurologic disease processes such as Diabetic-associated, Multiple Sclerosis and Parkinson’s disease.


Frequency of urination, Urgency to urinate, and Urge incontinence, the strong need to urinate followed by leaking and complete voiding.

After discussing your history and doing a physical exam, the provider may order tests such as urinalysis and cultures or ultrasounds to further evaluate the cause of overactive bladder. Urodynamics testing is sometimes necessary.

Primarily, the cause of the condition is treated as an underlying infection, or the underlying disease. Some other treatments may be used such as:

Bladder retraining

A voiding diary is kept of all episodes of urination and leaking and is then analyzed for a pattern of urination. This timetable is used to plan when to empty the bladder to avoid accidental leakage.


Drugs such as oxybutynin and tolterodine are taken orally to relax the smooth muscle of the bladder, reducing contractions and voiding accidents.

Sacral Nerve Stimulation (Interstim)

This is a reversible treatment for urge incontinence caused by overactive bladder. InterStim is an implanted neurostimulation system that sends mild electrical pulses to the sacral nerve, the nerve near the tailbone that influences bladder control muscles.

Posterior Tibial Nerve Stimulation (PTNS)

A small thin needle electrode is inserted near the ankle and then connected to a battery powered stimulator which then provides mild pulses up the leg and to the nerves that control your bladder for 30 minutes. This overtime will help control the overactive bladder symptoms.

Biofeedback/Pelvic floor therapy

Where electrodes are placed on bladder/pelvic floor muscle and hooked up to a computer to show the activity in real time. A trainer/therapist then evaluates the patient and takes the patient through exercises designed specifically to exercise the correct muscle.