From the Guidelines
Overactive bladder is a clinical diagnosis characterized by the presence of urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology, as defined by the International Continence Society 1.
Definition and Diagnosis
Overactive bladder (OAB) is a common urinary condition that affects millions of people worldwide, occurring when the bladder muscles contract involuntarily, even when the bladder isn't full. The diagnosis of OAB is predicated on the presence of urinary urgency, and urodynamic studies (UDS) are not required to make the diagnosis of OAB, unless in patients with atypical symptoms or those with an inadequate response to treatment 1.
Key Characteristics
The key characteristics of OAB include:
- Urinary urgency, defined as a sudden, compelling desire to pass urine which is difficult to defer 1
- Frequency, which is the need to urinate more often than usual
- Nocturia, which is the need to wake up at night to urinate
- Urgency urinary incontinence, which is the leakage of urine when the urge to urinate occurs
Treatment Options
Treatment for OAB typically begins with lifestyle modifications, such as:
- Fluid management
- Bladder training
- Pelvic floor exercises Medications, such as anticholinergics (e.g., oxybutynin, solifenacin, and tolterodine) or beta-3 agonists (e.g., mirabegron), may also be prescribed to relax the bladder muscle and reduce symptoms 1.
Advanced Therapies
For those who do not respond to medications, advanced therapies, such as Botox injections into the bladder, nerve stimulation therapy, or in severe cases, surgery, may be considered 1.
Importance of Shared Decision-Making
Once the diagnosis of OAB is made, the clinician and the patient should, through shared decision-making, formulate a personalized treatment approach taking into account evidence-based recommendations as well as patient values and preferences 1.
From the FDA Drug Label
Overactive bladder happens when you cannot control your bladder muscle. When the muscle contracts too often or cannot be controlled, you get symptoms of overactive bladder, which are leakage of urine (urge urinary incontinence), needing to urinate right away (urgency), and needing to urinate often (frequency) Overactive bladder occurs when you cannot control your bladder contractions. When these muscle contractions happen too often or cannot be controlled you can get symptoms of overactive bladder, which are urinary frequency, urinary urgency, and urinary incontinence (leakage)
Overactive bladder is a condition where the bladder muscle cannot be controlled, leading to symptoms such as:
- Urge urinary incontinence: leakage of urine
- Urgency: needing to urinate right away
- Frequency: needing to urinate often 2 3
From the Research
Definition of Overactive Bladder
- Overactive bladder (OAB) syndrome is a symptomatic diagnosis based on the presence of urgency, with or without urge incontinence, and usually accompanied by frequency and nocturia, in the absence of obvious pathologic or metabolic disease 4.
- OAB is characterized by urinary urgency, usually accompanied by increased daytime frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology 5.
- The current definition of OAB is "urgency, with or without urge incontinence, usually with frequency and nocturia in the absence of an underlying metabolic or pathologic condition" 6.
Symptoms of Overactive Bladder
- Symptoms of OAB include urgency, with or without urge incontinence, usually with frequency and nocturia 4, 7.
- Urgency is defined as a "sudden, compelling desire to pass urine that is difficult to defer" 6.
- Frequency and nocturia are also common symptoms of OAB 4, 7, 5.
Pathophysiology of Overactive Bladder
- The pathophysiology of OAB is multifactorial and involves myogenic, neurogenic, and urotheliogenic factors 8.
- Disturbance of any of these factors or a combination of these factors can contribute to OAB 8.
- Metabolic derangement, bladder outlet obstruction, and inflammation can increase the excitability of nerve, detrusor muscle, and alter the sensory and barrier functions of the urothelium 8.