Causes of overactive bladder in men

Overactive bladder describes a pattern of sudden urgency, frequent urination and waking to urinate; leakage may occur but is not required. In some men, an enlarged prostate restricts urine flow, so the bladder works harder and becomes more sensitive. Other contributors include urinary infection, bladder stones, constipation, diabetes, stroke, Parkinson’s disease, spinal or nerve disorders, and medicines that increase urine production. Caffeine, alcohol and fizzy drinks can aggravate urgency without being the underlying disorder. Sometimes no single cause is found.

Arrange a routine medical assessment if urgency is persistent, disrupts sleep or leads to accidents. Keep a bladder diary recording drinks, trips to the toilet, urgency and leakage. A clinician may review medicines, examine the abdomen and prostate, test urine and check whether urine remains after voiding. Further assessment such as urodynamic testing may be useful when the cause is unclear or symptoms are complicated. Treatment is matched to the cause and may include adjusting fluids and irritants, treating constipation or infection, bladder training, pelvic-floor exercises, medicines, or management of prostate obstruction. Do not stop prescribed medicine without clinical advice.

Seek urgent medical care if you cannot pass urine, have visible blood in the urine, fever with urinary symptoms, severe pain in the side or lower abdomen, or new weakness or numbness affecting the legs or groin. These features can indicate retention, infection, a stone or a nerve problem that needs prompt assessment. New loss of bladder control alongside severe back pain or loss of bowel control also warrants emergency evaluation.

Ask whether your urine stream, prostate, medicines or medical conditions could explain the symptoms; whether a urine test or bladder-emptying check is appropriate; and which drinks may be worsening urgency. You can also ask how to begin bladder training safely and what change should prompt an earlier follow-up.