Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed May 15, 2026
Can overactive bladder be cured?
OAB is a chronic condition, but many women manage it so well that their bladder stops running their life. Rather than thinking in terms of cure, it helps to think about control. With the right treatment, most women can reduce or nearly eliminate their symptoms.
A realistic perspective
I’m honest with my patients. I can’t promise a cure the way you’d cure an infection. But most women with OAB can get to a place where urgency and leaking no longer dictate their day. That’s a meaningful outcome.
Treatment options
There are several treatments that work for OAB. The right choice depends on your symptoms, your preferences, and your goals. Current guidelines support shared decision-making, so I walk through all the options with you rather than requiring you to try them in a fixed order.
Behavioral therapy
- Bladder retraining, where you gradually space out your trips to the bathroom
- Fluid management and diet changes
- Pelvic floor physical therapy, which goes beyond Kegels to include muscle relaxation, coordination, core and hip strengthening, and breathing techniques. We have in-office pelvic floor PTs who work with patients directly.
- Urge suppression techniques like deep breathing or quick pelvic floor squeezes to calm the urge
- About 50 to 80% of women improve with these approaches
Medications
- Anticholinergics or beta-3 agonists can quiet the bladder muscle
- These work best when combined with behavioral therapy
- One thing to know: fewer than half of women stay on OAB medications past six months, often because of side effects like dry mouth or modest results
Nerve stimulation and Botox
- Tibial nerve stimulation is an office procedure where a thin needle near your ankle sends a gentle signal to the nerves that control your bladder. It works for about 55% of women and has very few side effects.
- Botox bladder injections block the nerve signals that cause the bladder muscle to squeeze on its own. About 27% of women achieve complete dryness. The effect lasts 6 to 9 months, and repeat injections stay effective long-term.
- Sacral neuromodulation is an implanted device (sometimes called a “bladder pacemaker”) that sends steady signals to the nerves controlling your bladder. About 60 to 90% of women improve, and newer rechargeable batteries last 10 to 15 years.
You don’t have to try one treatment before another. Some women start with behavioral therapy, others go straight to Botox or nerve stimulation. We decide together based on what matters most to you.
Long-term management
OAB management is often ongoing, but that doesn’t have to feel like a burden.
- Behavioral strategies become second nature over time
- Medications can be adjusted or switched if side effects develop
- Botox can be repeated every 6 to 9 months as needed, with no loss of effectiveness
- Tibial nerve stimulation takes about one office visit a month after the initial series
- Sacral neuromodulation works continuously with occasional reprogramming
When symptoms resolve
Some women do see lasting improvement, especially when:
- OAB was triggered by something reversible like a medication side effect, a urinary tract infection, or hormonal changes after menopause
- Weight loss takes pressure off the bladder
- Behavioral strategies create lasting changes in bladder habits
The women who do best are the ones who stay active with treatment, especially the behavioral piece. Procedures and medications are effective tools, but the daily habits you build around bladder health make the biggest long-term difference.
References
- Lightner DJ, Gomelsky A, Souter L, Vasavada SP. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment 2019. J Urol. 2019;202(3):558-563. doi:10.1097/JU.0000000000000309
- Visco AG, Brubaker L, Richter HE, et al. Anticholinergic therapy vs. onabotulinumtoxinA for urgency urinary incontinence. N Engl J Med. 2012;367(19):1803-1813. doi:10.1056/NEJMoa1208872
- Amundsen CL, Komesu YM, Chermansky C, et al. Two-year outcomes of sacral neuromodulation versus onabotulinumtoxinA for refractory urgency urinary incontinence. Eur Urol. 2018;74(1):66-73. doi:10.1016/j.eururo.2018.02.011
- Peters KM, Carrico DJ, Perez-Marrero RA, et al. Randomized trial of percutaneous tibial nerve stimulation versus sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial. J Urol. 2010;183(4):1438-1443. doi:10.1016/j.juro.2009.12.036
- Peters KM, Carrico DJ, Wooldridge LS, Miller CJ, MacDiarmid SA. Percutaneous tibial nerve stimulation for the long-term treatment of overactive bladder: 3-year results of the STEP study. J Urol. 2013;189(6):2194-2201. doi:10.1016/j.juro.2012.11.175
- Sanses TVD, Zillioux J, High RA, et al. Evidence-informed, interdisciplinary action plan from the state-of-the-science conference on OAB and cognitive impairment. Urogynecology. 2023;29(1):60-73. doi:10.1097/SPV.0000000000001274
- Lukacz ES, Santiago-Lastra Y, Albo ME, Brubaker L. Urinary incontinence in women: a review. JAMA. 2017;318(16):1592-1604. doi:10.1001/jama.2017.12137
- Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol. 2019;31(6):485-493. doi:10.1097/GCO.0000000000000584
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