Tuesday, December 2, 2014


The hallmark symptom of overactive bladder is urgency, but the diagnosis also includes frequent urination, frequent interruptions of sleep because of the need to urinate -nocturia, and urinating unintentionally followed by an urge to continue urge incontinence.

Overactive bladder has many causes which can include diseases such as diabetes, medications such as diuretics, or lifestyle choices such as excessive consumption of caffeine or alcohol Bothersome urinary symptoms that are related to neurological such as multiple sclerosis are generally treated differently from overactive bladder in people who do not have neurological problems

People with the condition often have the symptoms for a long time before seeking medical care. Pain while urinating suggests that there is a problem other than overactive bladder.Management of overactive bladder is addressed in terms of quality of life since it is not a life-threatening problem.Overactive bladder is characterized by a group of four symptoms: urgency, urinary frequency, nocturia, and urge incontinence. Urge incontinence is not present in the "dry" classification.

The causes  of OAB is unclear, and indeed there may be multiple causes. It is often associated with overactivity of the detrusor muscle, a pattern of bladder muscle contraction observed during uro-dynamic study. It is also possible that the increased contractile nature originates from within the urothelium and lamina propria, and abnormal contractions in this tissue could stimulate dysfunction in the detrusor or whole bladder. Treatments for OAB are usually synonymous with treatments for detrusor overactivity. OAB is distinct from stress incontinence, but when they occur together, the condition is usually known as mixed incontinence.
Diagnosis of OAB is made primarily by ruling out other causes of overactivity of the bladder such as an infection or bladder tumor.  Additionally, urine culture may be done to rule out infection. The frequency/volume chart may be maintained and cystoscopy may be done to exclude tumor and stones. If there is an underlying metabolic or pathologic condition that explains the symptoms, the symptoms may be considered part of that disease and not OAB.

Treatment for OAB includes nonpharmacologic methods such as lifestyle modification (fluid restriction, avoidance of caffeine), bladder retraining or may involve the use of pharmaceutical agents such as anti muscarinic drugs.

Studies have shown that few people get complete relief from overactive bladder drugs and that all available drugs are no more than moderately effective. A typical person with overactive bladder may urinate 12 times per day. Medication may reduce this number by 2-3 and reduce incontinence events by 1-2 per day.


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