Overview

Two common causes for bladder problems are overactive bladder (OAB) and benign prostatic hyperplasia (BPH), or prostate enlargement.

Learn more about these two conditions and how to tell them apart.

According to the Urology Care Foundation, around 33 million Americans have OAB. They say estimate that 30 percent of men and 40 percent of women in the United States experience symptoms.

OAB is believed to occur due to malfunctioning nerves that trigger uncontrolled bladder muscle contractions that happen while the bladder is filling. The main symptom of OAB is a sudden urge to urinate that’s hard to control. It can be stressful, and it can get in the way of your day-to-day life. It normally responds well to medical therapy.

A few symptoms might indicate that you have OAB:

  • When you feel the urge to urinate, you may also leak a small amount of urine. This is called “urge incontinence.”
  • You have to use the bathroom more often than you normally do or more than eight times in 24 hours.
  • You need to urinate more than once during the night in the absence of contributing factors such as caffeine, alcohol, or excessive fluid intake at night. This is called “nocturia.”

According to the National Association for Continence, as many as 50 percent of men will experience BPH symptoms by the time they reach age 60 and 90 percent of men will have symptoms by age 85. Only men can have BPH because only men have a prostate gland. This gland plays an important role in sexual functioning and semen production. The prostate is right below the bladder, where the bladder connects to the urethra. The urethra is a tube that carries urine and semen out of the body, through the penis.

BPH likely results from changes in hormone levels that occur with age. An enlarged prostate can cause irritation or even obstruction. BPH isn’t life-threatening, but it can be extremely uncomfortable.

BPH has a number of symptoms, including:

  • a sudden need to urinate that can’t be put off, which is called urinary urgency
  • needing to go to the bathroom more often during the night, or nocturia
  • having to strain to urinate
  • a weak urine stream
  • dribbling after finishing urinating
  • having to urinate too often, or urinary frequency

Another common symptom of BPH is feeling like your bladder hasn’t fully emptied even after using the bathroom.

A person can have urinary symptoms that are unrelated to either OAB or BPH. This is why it’s important to talk to a doctor to find out your exact diagnosis.

If you have any of the following symptoms, you should seek immediate medical care:

  • blood in your urine
  • a complete inability to urinate
  • a fever or chills along with a painful, frequent, urgent need to urinate
  • extreme discomfort in the lower abdomen or urinary tract

OAB and BPH share some symptoms. Needing to urinate more frequently is one of them. Not feeling like you can put off urinating is another.

However, some details may help you tell the conditions apart. Assessing your risk factors may help you figure out your likelihood of having either OAB or BPH.

Risk factors for BPH

If you’re a woman, you can immediately rule out BPH because you don’t have a prostate. Some men are more likely to develop BPH than others. You’re more likely to have BPH if you:

  • have heart disease
  • have diabetes
  • are obese
  • have a poor diet
  • aren’t physically active
  • are over age 40
  • have a family history of prostate problems, such as BPH
  • use beta-blockers

Ethnicity is also a risk factor. Men of Asian descent are much less likely to develop BPH than white or black men.

Risk factors for BPH and OAB

Some risk factors for BPH that also increase a person’s risk for OAB include:

  • diseases that affect the brain or spinal cord, such as stroke, multiple sclerosis, spinal cord injury, Parkinson’s disease, or Alzheimer’s disease
  • aging
  • pelvic surgery
  • diabetic neuropathy
  • bladder infections, stones, or tumors

Risk factors for OAB

A family history of OAB can mean that you’re more likely to develop it. Women are more likely to develop OAB if they’ve given birth multiple times and gone through menopause. Men can develop both OAB and BPH.

See your doctor to get a diagnosis.

OAB and BPH are highly treatable. Your doctor will be able to tell you what treatment option is right for you. Unless your symptoms are severe, it’s unlikely you’ll need surgery. Medication, creating a urinary schedule, and bladder training exercises can help get OAB and BPH under control.