A sudden need to urinate is more common than previously known, but treatment is less common.

Diagnoses for overactive bladder more than tripled between 2013 and 2017, after the American Urological Association (AUA) released guidelines for the condition in 2012, researchers found.

However, diagnosis isn’t always leading to treatment.

Only about 19% of patients received some sort of prescription medication for their overactive bladder, and even fewer are being treated using therapies like nerve stimulation, researchers reported recently in the journal Neurourology and Urodynamics.

“Although rates of therapy uptake are low, they appear to be slowly increasing over time,” the research team led by senior author Dr. Ekene Enemchukwu, medical director of the Stanford Pelvic Health Canter in California, concluded.

Overall, as many as 43% of U.S. women and 27% of men suffer from overactive bladder (OAB), which involves an urgent need to urinate more frequently, researchers report.

For the study, researchers analyzed health and pharmacy claims data between 2013 and 2018 involving more than 1.8 million patients in the U.S. The patients' average age was 61, and 59% were women.

Results show that cases of overactive bladder increased by 369% from 2013 to 2017, after the AUA published guidelines for diagnosing and treating the condition.

Guidelines call for lifestyle modifications as the first line of treatment, followed by anticholinergic or beta-2 andrenergic drugs as second-line therapy. Those drugs help block bladder spasms and contractions, easing the urge to urinate.

As a third line of treatment, people with overactive bladder can be treated using implants that send electrical impulses to the nerves that control the bladder. Botox injections also can be used to relax bladder muscles.

Prescriptions for overactive bladder increased by 63% and third-line therapies by 50% during the study period, researchers found.

However, this amounted to roughly 1 in 5 patients getting a prescription and about 5% of those progressing to a nerve implant or botox, results show.

“Consistent with prior studies, we observed that men and nonwhite minorities were less likely to undergo third‐line therapies,” the research team wrote. “Previous studies have demonstrated that men with overactive bladder are undertreated in comparison to women.”

There are a number of reasons why few people get third-line treatments for overactive bladder, researchers said.

It might be too much trouble or embarrassing for them, or their insurance might not cover the procedure. Doctors also might not know enough about those options to recommend them to patients.

Researchers noted that the AUA just updated its practice guidelines again in 2024, “with a strong emphasis on personalized therapy approaches and shared decision‐making with patients.”

“In terms of future directions, a follow up study could evaluate the impact of the new [overactive bladder] clinical guideline on trends in therapy utilization,” the researchers wrote.