Overactive Bladder in Men: Causes, Symptoms, and Pelvic Floor Treatment Options

Overactive bladder, often referred to as OAB, is a common but frequently misunderstood condition in men. It is characterized by urinary urgency, frequent urination, and in some cases urine leakage. Many men assume these symptoms are a normal part of aging or are solely related to the prostate, but that is not always the case.

Overactive bladder is often related to how the bladder, pelvic floor muscles, and nervous system are functioning together. When these systems are not well coordinated, the bladder can send strong urgency signals even when it is not full.

What Is Overactive Bladder in Men

Overactive bladder is defined by a sudden and difficult-to-control urge to urinate. This urgency may occur with or without urinary incontinence. Common symptoms include frequent urination during the day, waking up at night to urinate, rushing to the bathroom, and feeling anxious about being far from a restroom.

OAB is not necessarily caused by having a small bladder. In many men, bladder capacity is normal, but the bladder is overactive due to muscle tension, nerve sensitivity, or learned bladder habits.

Common Causes of Overactive Bladder in Men

Overactive bladder rarely has a single cause. In men, it is often influenced by pelvic floor dysfunction, nervous system irritation, and mechanical factors within the pelvis.

Contributing factors may include tight or overactive pelvic floor muscles, chronic stress, prolonged sitting, poor posture, constipation and straining, a history of prostatitis or prostate irritation, previous pelvic or abdominal surgery such as hernia repair or prostate procedures, and frequent preventative or just-in-case urination.

These factors can cause the bladder to become hypersensitive, leading to frequent urgency and trips to the bathroom.

The Role of the Pelvic Floor in Urinary Urgency

The pelvic floor muscles play an essential role in bladder control. They help suppress urgency, coordinate bladder emptying, and provide feedback between the bladder and the brain.

When the pelvic floor muscles are tight, overactive, or poorly coordinated, they can send false signals of urgency. This is why some men experience worsening symptoms when they attempt pelvic floor strengthening exercises without proper evaluation. In many cases, the issue is not weakness but excessive muscle tension or poor relaxation.

Techniques That Help Reduce Urinary Urgency

Urge suppression techniques are often a key part of managing overactive bladder. When urgency occurs, immediately rushing to the bathroom can reinforce the bladder’s overreaction. Learning to pause, slow breathing, relax the abdomen, and allow the urge to pass can help retrain bladder signaling over time.

Pelvic floor relaxation is another important component. Many men benefit from learning how to reduce pelvic floor tension rather than strengthening. A pelvic floor physical therapist can determine whether relaxation, coordination training, or strengthening is appropriate.

Bladder retraining helps increase the time between bathroom visits in a gradual and controlled way. This involves establishing a consistent voiding schedule and using urge suppression strategies between planned bathroom breaks.

Breathing and nervous system regulation are also critical. The bladder is strongly influenced by the autonomic nervous system. Diaphragmatic breathing, reducing abdominal gripping, and improving rib and trunk mobility can calm bladder urgency.

Posture and pressure management can further reduce symptoms. Prolonged sitting, slouched posture, and excessive core tension can increase pressure on the bladder and pelvic floor. Improving posture and movement patterns can reduce irritation and urgency.

Why Pelvic Floor Physical Therapy Helps Overactive Bladder in Men

Pelvic floor physical therapy addresses the underlying contributors to overactive bladder rather than simply masking symptoms. Treatment may include a comprehensive pelvic floor assessment, manual therapy to reduce muscle tension, bladder retraining strategies, breathing and nervous system techniques, education on bladder habits, and coordination training between the core, diaphragm, and pelvic floor.

This approach is individualized and focuses on restoring proper function and control.

Medication and Overactive Bladder

While medications may help reduce bladder symptoms for some men, they do not address pelvic floor dysfunction or bladder habits. Side effects such as dry mouth and constipation are also common. Pelvic floor physical therapy is often used as a first-line or complementary treatment to address the root cause of symptoms.

You Do Not Have to Live With Urinary Urgency

Overactive bladder and urinary urgency are common but not normal. If frequent urination, nighttime waking, or urgency is affecting your quality of life, effective treatment options are available.

Pelvic floor physical therapy can help men regain control, improve confidence, and reduce urinary symptoms without surgery or long-term medication use.

If you are experiencing symptoms of overactive bladder or urinary urgency, a pelvic floor evaluation can help determine the cause and guide appropriate treatment. Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.