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Ask The Doc: Small Bladder Vs. Overactive Bladder? What’s The Difference?


I hear a lot of different terms to describe urinary incontinence, and some of them are so similar that it can get pretty confusing. In particular, I was wondering what the difference is between a small bladder and an overactive bladder?


This is such a good question! When it comes to the medical field, we’re really great at naming things that other doctors can understand but that aren’t always easy for laypeople to make sense of. This is not one of those times. That’s because there’s actually no such thing as a small bladder!

Anatomically, everyone’s bladder is the same. What’s different is the way the bladder functions. You may think you have a small bladder because it doesn’t seem like you can hold a lot of urine, but the reason doesn’t have anything to do with its size. Instead, you’re not able to hold a lot of urine because the muscle walls of the bladder go through sudden, involuntary contractions. The bladder muscle becomes overactive, giving you the urge that you always have to pee.

Those sudden urges, along with the frequent need to find a bathroom, urgency that causes involuntary leaks, and nocturia – that is, having to go multiple times at night – are all symptoms of what we call overactive bladder or OAB.

Risk factors for OAB include nervous system abnormalities such as spinal cord injuries, dementia, stroke, Parkinson’s Disease, multiple sclerosis, and other nerve trauma or damage. Other causes can include urinary tract infections, bladder stones, bladder cancer, and an enlarged prostate. Obesity and diabetes also increase the risk of having OAB.

You should note that the risk of overactive bladder increases with age. Women are more likely to have it than men due to weaker pelvic floor muscles caused by menstruation, pregnancy, or menopause. Despite the increasing prevalence as we get on in years, however, OAB is not a normal part of the aging process, and we have a number of highly effective treatments to help you overcome your symptoms.


  1. Eilber, MD, K. (2015). What is the Difference Between a Small Bladder and an …. [online] EmpowHER. Available at:http://www.empowher.com/overactive-bladder/content/what-difference-between-small-bladder-and-overactive-bladder-dr- [Accessed 6 Apr. 2015]

  2. Arnold, J., McLeod, N., Thani-Gasalam, R. and Rachid, P. (2012). RACGP – Overactive bladder syndrome –management and treatment options. [online] Racgp.org.au. Available at:http://www.racgp.org.au/afp/2012/november/overactive-bladder-syndrome/

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The NAFC Ask The Doc series provides answers to some of our reader’s most common questions from a group of experts in the fields of urology, pelvic floor health, bowel health, and absorbent products. Do you have a question you’d like answered? Click here to Ask The Doc!


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