Bladder Control Problem (Overactive Bladder)

Bladder control problems, or overactive bladder, prevent you from controlling when and how much you urinate. You may experience unexpected small or large leaks, use the bathroom very frequently, or you may have the feeling of not being able to completely empty your bladder. Some people experience a combination of these symptoms.

Causes & symptoms of bladder control problems

Normally, as your bladder stores urine, your pelvic floor muscles contract to support your bladder and hold urine in without leaking. Bladder control problems occur when your pelvic muscles weaken.There are different types of bladder control problems:

  • Frequent urges to urinate (urgency-frequency)
  • Inability to hold urine/leaking (urge incontinence)
  • Inability to urinate (complete urinary retention)
  • Incomplete bladder emptying (partial urinary retention)
  • Leaking due to abdominal contractions (stress incontinence) (InterStim Therapy does not treat stress incontinence.)

Risk factors for overactive bladder

Menopause or an enlarged prostate may increase your risk for bladder control problems. Bladder control problems are not a natural part of aging. Pregnancy and childbirth, obesity, weak pelvic muscles, diabetes, prostate cancer, bladder cancer or stones, and neurological disorders can also be contributing factors. In addition, certain medications, high calcium levels, constipation, or inactivity can put you at risk.

Diagnosis of overactive bladder

Diagnosis is based on symptoms and voiding diary. A voiding diary is a detailed record of the amount intake of fluids and the amount of urine you pass in a 24 hour period. Talk to our doctors about your symptoms and how they are affecting your day-to-day life. Your doctor will make a diagnosis based on your symptoms.

Bladder control treatments

There are several treatment options for overactive bladder, including Medtronic’s innovative InterStim®neurostimulator. If your life has been disrupted by bladder problems, and other treatments have not worked for you or have caused intolerable side effects, talk to your doctor about how you can get back to normal.

Botox Injections

Botox, a botulinum toxin that relaxes muscle contractions, has long been used in cosmetic and dermatologic practices, then more recently by neurological practice to treat migraines. Now Botox injections have been approved for the treatment of overactive bladder and urinary incontinence.

Botox treatments significantly reduce incontinence symptoms, including urge urinary incontinence, urgency, frequency and urinary leakage. The injected Botox reduces symptoms by relaxing the muscles of the bladder and reducing bladder muscle contractions to increase bladder storage capacity.

Patients typically experience symptom relief with in one week of the injection treatment. However, Botox injections are not a permanent procedure and symptom relief will typically last between three and six months before requiring reapplication.

Behavioral techniques

Some people can reduce the symptoms of bladder control problems with healthy lifestyle habits, diet modification, biofeedback, bladder retraining, and pelvic muscle exercises.


Medications may be prescribed by your doctor to help control the symptoms of your bladder control problem. The various types of medications used for bladder control problems focus on the muscles associated with bladder function.

Sacral nerve stimulation

Doctors may recommend Interstim® sacral nerve stimulation for those people who have failed or could not tolerate more conservative treatments. This reversible treatment uses a small implanted neurostimulator to send mild electrical pulses to the sacral nerve to reduce symptoms.  Interstim®  has been used to treat more than 50,000 people worldwide since 1994. More information is available at

Permanent surgical procedures

In some cases, people choose bladder augmentation (changing bladder size), bladder denervation (cutting or excising part of a nerve), or bladder removal to treat their bladder control problems.

Pacific Urology is leading a clinical trial on a new treatment

If you have tried the above conservative therapies and you still have your symptoms, you could consider participating in a clinical trial for a new treatment device. Dr. Parminder Sethi is leading the clinical investigation of this new technology.

The device is an implantable tibial nerve stimulator (ITNS), a miniature, self-powered unit placed in the lower leg under local anesthesia. The ITNS has a projected battery life between 7-10 years and requires no patient activation or recharging. The U.S. Food and Drug Administration (FDA) has approved this first human study of the ITNS. The ITNS is not approved for commercial distribution and is limited to investigational use.

Dr. Sethi is a diplomate of the American Board of Urology since 2000. He is currently a fellow of the Royal College of Surgeons. He completed his urology residency at Ohio State University and is fellowship trained in neuro-urology and incontinence at the University of Iowa Hospitals and Clinics. Dr. Sethi is one of a few urologists who specialize in the use of advanced technology to treat incontinence and overactive bladder, and was instrumental in developing Pacific Urology’s Continence Center.

Learn more

For more information or to schedule an appointment to learn if you are eligible for the ITNS study, contact us online or call our office at 925-937-7740.


  1. “Neurophysiology of Micturition,” chapter 2, p23 in Female Urology, Urogynecology and Voiding Dysfunction, edited by Vasavada, et al, 2005.

Contact us to learn more about treating bladder control issues or to schedule an appointment with one of our urologists.