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Overactive Bladder or Enlarged Prostate: Which is it?

Thursday 10 September 2020
4 minute(s) read
Dr..Jubil Tom

Medically reviewed by

Dr. Jubil Tom, MD

on 6 November 2020

Table of Contents

I. Overview

a. What is Overactive Bladder?

b. What is an Enlarged Prostate?

II. Symptoms

a. Overactive Bladder Symptoms

b. Enlarged Prostate Symptoms

III. Causes

a. What Causes Overactive Bladder?

b. What Causes an Enlarged Prostate

IV. Treatments

a. Overactive Bladder Treatments

b. Enlarged Prostate Treatments


Overactive bladder and an enlarged prostate are two common causes of bladder problems. While they are different conditions, they have many common symptoms and can be confused for one another. Keep reading to learn more about these conditions, including their causes, symptoms, and treatments.

a. What is Overactive Bladder?

Overactive bladder (OAB) is a very common condition and affects approximately 33 million people in the United States. [1] OAB is slightly more common in women and around 40 percent of women show symptoms compared to 30 percent of men. [2]

Overactive bladder is not simply having sudden occasional urges to urinate or infrequent incontinence; this condition is a collection of symptoms that affect urination and causes regular sudden urination. When not treated with medications like Myrbetriq (mirabegron), Detrol LA (tolterodine), and Vesicare (solifenacin), OAB can severely affect your quality of life.

b. What is an Enlarged Prostate?

An enlarged prostate is also known as benign prostatic hyperplasia (BPH). Unlike overactive bladder, only men develop BPH and it affects around 14 million Americans. [3] As the prostate grows in size, it presses against the urethra and affects urination. As well as causing bladder symptoms, BPH can also cause complications, including bladder, kidney, and urinary tract problems. [4]

BPH becomes more common as men age. While it is rare in men younger than 40, around one-third of men have moderate symptoms by age 60, and around half by age 80. [4]

Four urinals in a men’s bathroom


a. Overactive Bladder Symptoms

The most obvious symptom of overactive bladder is needing to urinate frequently or urgently. You may have a sudden and intense urge to urinate, only to pee a small amount. Other OAB patients may leak small amounts of urine during these urges.

People with an overactive bladder may also urinate multiple times a day or night. If you regularly urinate more than eight times a day, or more than once during the night, then you should speak to your doctor about OAB. [5]

b. Enlarged Prostate Symptoms

The symptoms of benign prostatic hyperplasia are similar to those of OAB. This includes frequent urination, especially during the night. People with BPH also suffer from sudden urges to urinate, feeling like the bladder is full after urinating, weak flow, and night-time urination.

There are also symptoms of an enlarged prostate that differ from OAB symptoms. These differing symptoms include difficulty starting to urinate, needing to strain to urinate, or stopping and starting multiple times during urination. [6] If these symptoms seem familiar, you should speak to a medical professional.


a. What Causes Overactive Bladder?

Overactive bladder is caused by damaged nerves surrounding the bladder. Usually, when a person’s bladder is full or nearly full, the brain sends a signal to the bladder so that the person knows to go to the bathroom. Once ready, muscles in the bladder contract, which forces the urine out of the urethra and out of the body. [7]

Water dripping out of a tap

However, when the nerves that connect the brain and the bladder are not functioning correctly, the bladder muscles can spasm. The brain then incorrectly thinks that the bladder is full, which is what causes the sudden need to urinate.

b. What Causes an Enlarged Prostate

For most men, their prostate continually grows throughout their lives. For many BPH patients, it is this continual growth that causes their urinary symptoms. As the prostate gets larger, it can block the flow of urine through the urethra.


When treating a bladder condition such as an overactive bladder or benign prostatic hyperplasia, it is very important that it is diagnosed correctly. Both conditions are highly treatable. Before visiting a doctor, keep a ‘bladder diary.’ This can be used to keep track of your symptoms and can help to diagnose your condition. [8]

a. Overactive Bladder Treatments

Overactive bladder is typically treated using antispasmodic medications such as Myrbetriq (mirabegron), Detrol LA (tolterodine), and Vesicare (solifenacin). These medications work by relaxing the smooth muscles inside the bladder. This reduces the frequency of urgent urination.

A cup of coffee on a white sheet

Lifestyle changes can also help reduce the severity of overactive bladder. Changing aspects of your diet can help reduce the frequency of OAB symptoms. Exercises such as Kegels can also help strengthen your pelvic muscles. Having stronger muscles and more control over them can also help strengthen your pelvic floor and bladder.

b. Enlarged Prostate Treatments

When treating benign prostatic hyperplasia, treatment will depend on your age, health, and size of the prostate. Often BPH is treated using medications including Cialis (tadalafil) and Flomax (tamsulosin). BPH medications work by relaxing the muscles in the prostate and the bladder neck, which makes it easier to urinate. For more severe cases of BPH, your doctor may suggest a minor surgery or other therapy treatment.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.


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