Talk to your clinician about overactive bladder

1. Know who will treat your OAB

You may also see a doctor, nurse practitioner, or physician colleague to get help with OAB. And these clinicians may have different specialties. It is helpful to understand who is treating you and what their specialties are.

primary care: We manage overall health care and prevention, and often diagnose and treat OAB. If more specialized treatment is needed, you will be referred to a specialist.

obstetrics and gynecology: A female reproductive health specialist can diagnose and manage OAB. Depending on your symptoms and treatment needs, you may be referred to a urologist or urogynecologist for further evaluation or specialized care.

urology: Specializes in the urinary system, including the bladder.

Urogynecology: Focuses on pelvic floor issues, including OAB and urinary incontinence.

geriatric medicine: This is specialized treatment for the elderly. Given that up to half of women over the age of 65 experience OAB, clinicians in geriatric units observe this condition fairly regularly.

2. Keep a bladder diary for at least three days.

You can leave notes on your computer, phone, or laptop, or download a bladder or voiding log. This allows clinicians to have a clearer picture of what is happening over time rather than trying to remember it on the spot.

Write it down:

• What time do you go to bed/wake up?
• How many times do you wake up at night to urinate?
• What, how much and when to drink
• When you need to urinate urgently
• How much urine did you urinate? If you want accurate measurements, you can use a measuring cup.
• If you have leakage, pain, burning, or discomfort in your bladder

3. Make a list of your medications

Some medications, such as diuretics (“water pills”), can trigger or worsen OAB symptoms, so make a list of all medications you take, including:

• prescription drugs
• Over-the-counter medications such as painkillers, allergy medications, etc.
• vitamins and supplements

4. Share how OAB affects you.

Although your clinician will ask you questions related to urination, it is important to understand how these symptoms affect your life.

• Avoid going out?
• Does frequent trips to the bathroom affect your work or activities?
• Are you tired because you keep urinating at night?
• Is OAB affecting your relationships, social life, or sex life?
• Should I wear pee pads, liners, or leak-proof underwear? How often should I change it?

5. Prepare a list of questions

You don’t want to leave your appointment only to remember to ask questions later. Think ahead and write down your questions. The list can be long, so highlight the most important items to ask first in case you don’t have access to everything. Questions may include:

• What causes my symptoms?
• Do you need testing? So what is the test?
• What treatment do you recommend?
• What side effects may occur from treatment?
• Is there anything I can do to help at home?

6. Use clear language

Clinicians prefer clear and direct language to avoid confusion. There’s no need to be ashamed. Remember that OAB is common. You can start the conversation by saying something like:

• Having to get up frequently at night to urinate.
• I’m tired of waking up to pee so often, and it’s affecting my work/daily life/life.
• Sometimes you urinate so much that you can’t go to the bathroom.
• I’m embarrassed because I’m leaking urine. It’s preventing me from participating in activities.

7. Make sure your concerns are addressed before you leave.

Make sure your questions and concerns are addressed. You might also ask:

• Should I keep keeping a bladder diary?
• What should I do if my symptoms get worse?
• When will I know the test results?
• How long will it take to know if treatment helps?
• When should I schedule a follow-up?

Factors that make living with OAB more difficult

Anyone can develop OAB, but some groups are more affected. One study found that adults with OAB who were experiencing social or economic hardship were significantly more likely to feel the impact of OAB on their lives. This includes people like:

• unemployed person
• low income
• Worried about having enough food
• If you are homeless or have unstable housing
• no health insurance

If you have been diagnosed with OAB but are worried about following your treatment plan or going to appointments, mention this. There may be options such as lower-cost medications, video appointments, or local resources that your clinician can tell you about.