The short answer: An overactive bladder means a sudden, desperate need to pee, often with going more often and getting up at night. It is common in men, it overlaps with the symptoms of an enlarged prostate, and bladder training, cutting back on caffeine and alcohol, and a visit to your GP all help.
What an overactive bladder feels like
A patient leaflet from Kingston and Richmond NHS Foundation Trust describes it as a sudden, desperate need to pass urine. The bladder muscle squeezes too often, sometimes when there is not much in the bladder at all.
The usual signs:
- Urgency. A sudden need to go that is hard to put off.
- Frequency. Bladder Health UK describes this as needing to pass urine more than 8 times during the day.
- Getting up at night. Needing to get out of bed to pee more than once.
- Leaks with the urge. When a leak comes with that sudden need, or just after, the NHS calls it urge incontinence.
It is more common than most men think. The Kingston and Richmond leaflet says it affects at least 1 in 10 adult women and men. Not everyone leaks. Bladder Health UK says about one in three people with an overactive bladder have leaks with the urge.
Why it happens in men
Often there is no single cause. The NHS lists several things that can bring on urge leaks:
- drinking too much alcohol or caffeine
- not drinking enough, which leaves strong, concentrated urine that irritates the bladder
- constipation
- urinary tract infections
- neurological conditions
- certain medicines
For men there is also the prostate. An enlarged prostate is most common in men over 50. Its symptoms include needing to pee more often or urgently, including at night, and dribbling after you finish. Bladder Health UK notes that men with a blockage from an enlarged prostate may have overactive bladder symptoms. The two look alike, which is one good reason to get checked rather than guess.
The NHS is clear that an enlarged prostate is not caused by prostate cancer and does not raise your risk of it. But similar symptoms can sometimes come from something more serious, so they are worth showing to a GP.
Bladder training
Bladder training teaches the bladder to hold more. When you feel the urge, you hold on for a short time, then gradually stretch the gap over a few weeks. The NHS says a course usually lasts at least 6 weeks.
It feels slow at first. Most things that work do.
A bladder diary helps. The NHS suggests recording what you drink, how often you go and how often you get an urgent need to go, for at least 3 days. It gives you and your GP something to work from.
Caffeine, alcohol and what you drink
Caffeine and alcohol can both make you pee more, and the NHS suggests cutting down on both. Tea, coffee and cola all contain caffeine, so decaf versions are worth a try.
The Kingston and Richmond leaflet also suggests avoiding fizzy drinks, citrus fruits and smoking.
What you should not do is stop drinking to get through the day. Drinking too little makes urine more concentrated, which can irritate the bladder. The same leaflet suggests 6 to 7 half pint glasses of fluid a day.
Pelvic floor exercises
The pelvic floor muscles surround the bladder and urethra and help control the flow of urine. For bladder leaks, the NHS recommends a programme of at least 8 squeezes, at least 3 times a day, for at least 3 months.
They take a while to work, so it is worth starting now. If you are not sure you are squeezing the right muscles, the specialist physiotherapists at your local continence service can help.
Treatments your GP may offer
If lifestyle changes and bladder training are not enough, there are medicines. The NHS mentions antimuscarinics for overactive bladder, and a different type of medicine if those do not suit you or do not help. Both aim to help the bladder hold urine for longer.
An enlarged prostate has its own medicines and, for some men, surgery. That is another reason your GP will want to know what is behind your symptoms before choosing.
If medicines do not work, the Kingston and Richmond leaflet lists further options at hospital, including Botox injections and nerve stimulation.
When to see a GP
See a GP if you have difficulty peeing or need to pee more often than usual. The NHS says bladder leaks are a common problem, and you should not feel embarrassed talking about them.
Ask for an urgent GP appointment or get help from NHS 111 if:
- you have blood in your pee
- it hurts when you pee
- you cannot pee at all
And if your leaks are more than light, do not just manage them quietly. Get them looked at.
Getting on with your day
Urgency leaks vary. Some are a small spot before you reach the toilet. Others are larger, and those are a job for your GP rather than your underwear.
The Everyday suits small leaks on and off through the day, which is how a lot of urgency leaks turn up. If yours are mainly the last drop after you have been, The Active is made for that. For long days away from home, The Ultra has three washable pads that clip in, so you can swap a fresh one in.
Frank's Pants are for light leaks. If yours are heavier, see your GP or ask about your local continence service.
Your first pair is covered by Frank's Word, our 60 day guarantee. If it does not keep you dry and comfortable, you get your money back.
Frequently asked questions
What causes a sudden urge to pee in men?
Common triggers include caffeine, alcohol, not drinking enough, constipation and urinary infections. In men, an enlarged prostate can cause similar symptoms, so it is worth seeing a GP.
Is an overactive bladder the same as an enlarged prostate?
No, but the symptoms overlap. Both can mean needing to go urgently and often, including at night. A GP can help work out which is behind yours.
How long does bladder training take?
The NHS says a course of bladder training usually lasts at least 6 weeks. It works by gradually lengthening the time between feeling the urge and going.
Can Frank's Pants handle urgency leaks?
The Everyday suits small leaks on and off through the day. If your urgency leaks are more than light, see your GP rather than relying on underwear.
This article is general information, not medical advice. Always follow the guidance of your GP or healthcare team.