There are different ways to treat OAB, and the right option for you depends on your symptoms, how they affect your life, your health history, any past surgeries, and what treatments are available where in your area. Your personal preferences and beliefs also matter in choosing the right treatment.

Self management of symptoms

As a first step, your doctor may suggest making some simple changes to your daily routine. These changes are things you can try on your own, such as:

Changing when and how much you drink. Your doctor or nurse can help with this.
Drinking less in the evening to avoid nighttime trips to the bathroom.
Cutting back on things like artificial sweeteners, spicy foods, citrus, caffeine, and alcohol, which can irritate your bladder.
If you are having urine leakage, using an absorbent pad to protect your clothes.
Trying to hold your bladder a bit longer when you feel the urge to go. This can help retrain your bladder to hold more liquid, so you can go longer between bathroom trips.
Doing pelvic floor exercises to strengthen and relax the muscles. A physiotherapist can show you the right exercises to do.
Keeping a healthy weight, as excess weight can put pressure on the bladder and increase the risk of leakage.

These changes can help you manage your symptoms.

Medicines

If self-management doesn’t help you with your OAB symptoms, your doctor may recommend medicine. This can help reduce the urge to urinate, cut down on toilet trips, and stop leakage.

There are several types of medicines that can help with overactive bladder symptoms. Your doctor will talk with you about the different medicines available and their side effects, so you can decide together which one might work best for you.

Medicines for overactive bladder are of two types:

Antimuscarinics – A group of different drugs.
Beta-3 agonists – Like mirabegron.

The medicines you’re offered will depend on things like your age, symptoms, medical history, any other medicines you're taking, what’s available in your area, and your personal preferences.

If you're taking other medicines, your doctor might change them to make sure they work well with your OAB treatment. One benefit of medication is that if it doesn’t work for you, you can stop and try something else.

Antimuscarinic medicines: these relax the bladder muscles to help reduce the urgent need to go and the frequency of bathroom visits. Some examples are:
1. Oxybutynin
2. Tolterodine
3. Solifenacin
Potential side effects of antimuscarinic medicines
Antimuscarinic medicines can cause side effects like dry mouth, constipation, sensitivity to light, hot and flushed skin, and a fast heartbeat. In rare cases, older adults may have confusion, memory loss, or trouble thinking, but these problems should stop as soon as the medication is stopped.
These medicines are not safe for pregnant or breastfeeding women, people with serious liver or kidney problems, those with very high blood pressure, or anyone under the age of 18.
If one type of antimuscarinic medicine causes problems, your doctor may suggest a different one. If pills cause dry mouth, using a skin patch or ointment might be a better option.
Beta-3 Agonists medicine: these help the bladder hold more urine and reduce the need to go. One example is:
1. Mirabegron
Potential side effects of Beta-3 Agonist medicine
Mirabegron can sometimes raise your blood pressure, so it’s important to have it checked after you start taking it. It can also cause side effects like urinary tract infections, diarrhoea, dizziness, headaches, or trouble urinating. If you notice any of these, be sure to contact your doctor right away.
This medicine is not safe for pregnant or breastfeeding women, people with serious liver or kidney problems, those with very high blood pressure, or anyone under the age of 18.

Remember, just because a side effect is listed doesn’t mean you will experience it. Many people take OAB medicines without having any side effects at all.

If either mirabegron or antimuscarinic medicine alone doesn’t help, your doctor may suggest combining both.

Botox or Botulinum toxin

Botulinum toxin, or Botox, is well known for cosmetic use but can also help treat overactive bladder. If lifestyle changes and medications haven’t worked, this treatment may be an option. It works by calming the nerves in the bladder, helping it relax. This can lessen the strong urge to urinate and the need to go as often. For some people, it can also help prevent leaks, making daily life easier and more comfortable.

Botulinum toxin, or Botox, injections are used to treat overactive bladder. First, a numbing fluid is put in your bladder to make the procedure more comfortable. Then, the doctor uses a thin tube with a camera (called a cystoscope) to inject the botulinum toxin into your bladder. The cystoscope is inserted through your urethra. If needed, you can have the procedure done while you’re under general anaesthesia.