Overactive bladder
Urgency, frequency, urge leakage: understand the pattern first.
With overactive bladder the urge to go arrives suddenly and hard to ignore, trips to the bathroom stack up, and sometimes urine leaks before you get there. Plenty of people live with it; nobody has to accept it as just getting older.
Signs
Urgency, frequent urination day and night, urge leakage, small amounts each time, and urgency triggered by sounds or sights.
02How it is evaluated
A review of symptoms, fluids and medications; an exam; often a bladder diary kept for several days; urinalysis and culture; a post-void residual check; and, when needed, urodynamic testing or cystoscopy.
03Treatment options
Treatment starts with understanding the pattern rather than reaching for a prescription. Our urologists may start with habit and fluid changes or a medicine, then consider bladder Botox given through a scope or InterStim sacral nerve stimulation.
04If you searched for PTNS
Our urologists offer Altaviva as an implanted device rather than needle PTNS sessions. Altaviva works on the tibial nerve, and whether it suits your symptoms is something to settle at a visit.
05Who we see
In Johns Creek and Cumming, plenty of women make a first appointment because of bladder symptoms. Men are seen for them too.
Urgency, frequency, and urge leakage, named as a pattern
Overactive bladder is a pattern: a sudden need to go, trips that add up through the day, waking at night, and sometimes leaking on the way. It is common, and it is treatable, but it is not something we label from a single busy afternoon. Our urologists can help if this pattern has lasted, if a first medicine has not been enough, or if you have started to map errands around bathrooms.
Visits are at 10730 Medlock Bridge Rd and at the Cumming Clinic. We use a history, a diary when it will help, a urine test, a post-void residual, and, in some people, urodynamics or cystoscopy, which is how the evaluation is laid out on our overactive-bladder page.
The treatment ladder we actually use
Lifestyle measures and bladder training, medicines, pelvic-floor therapy, bladder Botox, InterStim sacral-nerve stimulation — including the InterStim X and InterStim Micro systems we describe — and the Altaviva tibial-nerve implant. We move up that list when a simpler step has been given a fair try or is a poor fit, and we say the risks before we implant anything.
When to come in, and who you may sit with
Book a visit or call 678-344-8900 when urgency is running the day, when leaking has started, or when you want a urologic reading of a pattern you have been managing alone. If you cannot pass urine, or if you have fever with pain, use emergency care.
A two-day diary, a medicine list, and identification will help. Dr. Nicholas Farber and Dr. Neal Patel both practice in the Johns Creek building and both appear in the official videos linked below.
Do I have to fill a diary before you will see me?
No. A diary is useful, and we may ask for one, but it should not delay the first appointment.
Will Botox be discussed on day one?
We may mention it as part of the list. We do not jump to it before we understand the pattern and what you have already tried.
Is this the same as a urine infection?
An infection can mimic some of these symptoms, which is one reason we test the urine. Overactive bladder is a different diagnosis once infection has been looked for.
Official overactive-bladder videos from two urologists who work in Johns Creek
Dr. Nicholas Farber and Dr. Neal Patel, who both practice at Johns Creek, talk through overactive bladder and bladder control on official practice videos. They are meant to make the vocabulary familiar before or after your visit, not to assign you a device.
- Watch: Dr. Nicholas Farber explains Overactive Bladder
What the video covers. Titled "Dr. Nicholas Farber explains Overactive Bladder." The public description covers symptoms and treatment options for overactive bladder, featuring Dr. Farber.
Watch: Urologist Dr. Neal Patel discusses Regaining Control of your BladderWhat the video covers. Titled "Urologist Dr. Neal Patel discusses Regaining Control of your Bladder." The public description identifies Dr. Neal Patel as a urologist and robotic surgery specialist who focuses on voiding dysfunction, including overactive bladder, urinary retention, and fecal incontinence.
- Watch: Dr. Neal Patel teams with Medtronic to discuss Bladder Control
What the video covers. This official Advanced Urology video is titled "Dr. Neal Patel teams with Medtronic to discuss Bladder Control." Dr. Neal Patel discusses bladder control.
Can an overactive bladder visit start in Cumming?
Yes. Evaluation and medicine management can begin at either office. Procedures, including sacral nerve stimulation when that is the plan, are scheduled at Johns Creek.
What should I bring?
A medicine list, a brief note of how often you void or leak if you have kept one, and any prior urine tests. The packing-list page on this site has the rest.
When should this be treated as emergency care?
An urgent need to void is clinic work. If you cannot urinate at all, or have fever with pain, go to an emergency department.
Do you treat leakage as well as urgency?
Yes. Urge leakage is part of the same conversation. Stress leakage has its own evaluation, described on our bladder leakage page.
Whenever a visit would help, the Johns Creek and Cumming teams are a phone call or a booked appointment away.