Overactive bladder

Overactive bladder
Other namesOveractive bladder syndrome
SpecialtyUrology
SymptomsFrequent feeling of needing to urinate, incontinence
ComplicationsUTIs, anxiety
Usual onsetMore common with age
DurationChronic
TypesAge-related, or Secondary to other illness
CausesOld age; detrusor muscle injury; over-consumption of water and caffeine; UTI; pelvic injury
Risk factorsOld age, obesity, caffeine, constipation
Diagnostic methodBased on symptoms after ruling out other possible causes
Differential diagnosisOther neurological conditions
TreatmentPelvic floor exercises, bladder training, drinking moderate fluids, weight loss, medications, Botox, surgery
MedicationAnticholinergic drugs, β3 agonists
PrognosisOften but not always incurable
Frequency~40% of elderly adults, increasing with age

Overactive bladder (OAB) is a common condition where there is a frequent feeling of needing to urinate to a degree that it negatively affects a person's life. Overactive bladder is characterized by a group of four symptoms: urgency, urinary frequency, nocturia, and urge incontinence.

Urinary frequency is defined as urinating more than about 7-8 times in one day. The frequent need to urinate may occur during the day, at night, or both. The number of episodes varies depending on sleep, fluid intake, medications, and up to seven is considered normal if consistent with the other factors.

In addition, patients with OAB experience urinary urgency, a sudden feeling that they have to get to the bathroom very quickly.

Lastly, they may experience nocturia, which is waking up at night to urinate.

Loss of bladder control (urge incontinence) is a form of urinary incontinence characterized by the involuntary loss of urine occurring for no apparent reason while feeling urinary urgency as discussed above, and often occurs with this condition. This condition is also sometimes characterized by a sudden and involuntary contraction of the bladder muscles, in response to excitement or anticipation.

OAB is distinct from stress urinary incontinence (SUI), but when they occur together, the condition is usually known as mixed urinary incontinence. Treatment of mixed urinary incontinence usually focuses on the more bothersome component between OAB and SUI.

Overactive bladder affects approximately 11% of the population and more than 40% of people with overactive bladder have incontinence. Conversely, about 40% to 70% of urinary incontinence is due to overactive bladder. Overactive bladder is not life-threatening, but most people with the condition have problems for years.