From the Guidelines
Overactive Bladder (OAB) is a clinical diagnosis characterized by the presence of bothersome urinary symptoms, including urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence (UUI), in the absence of urinary tract infection or other obvious pathology. According to the International Continence Society (ICS) definition, as stated in the 2019 guideline amendment by the American Urological Association (AUA) and the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) 1, OAB is primarily diagnosed by the presence of these symptoms. The hallmark symptom of OAB is urgency, which is defined as the "complaint of a sudden, compelling desire to pass urine which is difficult to defer" 1.
Key Characteristics of OAB
- Urinary urgency
- Frequency
- Nocturia
- Urgency urinary incontinence (UUI)
- Absence of urinary tract infection or other obvious pathology
The diagnosis of OAB is often one of exclusion, and treatments are aimed at relieving symptoms rather than reversing pathophysiologic abnormalities 1. Understanding the pathophysiology and risk factors for the development of OAB is crucial for both treatment and prevention. Future research should address the entire spectrum of research endeavors, including epidemiology, quality of life measurements, treatment modalities, and basic bladder physiology, as highlighted in the 2019 AUA/SUFU guideline amendment 1.
Importance of Accurate Diagnosis
Accurate diagnosis of OAB is essential to provide appropriate treatment and improve the quality of life for patients. The 2019 guideline amendment by the AUA and SUFU 1 provides a comprehensive overview of the diagnosis and treatment of OAB, emphasizing the need for a thorough evaluation to exclude other underlying conditions that may be contributing to the symptoms. By prioritizing the most recent and highest quality evidence, healthcare providers can make informed decisions and provide optimal care for patients with OAB.
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 (OAB) is a condition where the bladder muscle cannot be controlled, leading to symptoms such as:
- Urge urinary incontinence: leakage of urine
- Urgency: a strong need to urinate right away
- Frequency: needing to urinate often 2
From the Research
Definition of Overactive Bladder (OAB)
- Overactive bladder (OAB) is a common syndrome characterized by unstable bladder contractions, resulting in urinary urgency, frequency, and nocturia in the absence of detectable disease 3.
- OAB is a chronic, distressing condition characterized by symptoms of urgency and frequency, with or without urge urinary incontinence 4.
- OAB syndrome is a condition that involves 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.
Prevalence of OAB
- Large studies suggest that >10% of the general population is symptomatic 3.
- OAB affects millions of people of all ages and both sexes worldwide, with greater prevalence in women and the elderly 4.
Symptoms of OAB
- Urinary urgency (sudden overwhelming urge to urinate) 4.
- Frequency (urinating more than eight times daily) 4.
- Nocturia (waking up to urinate at night) 3, 5.
- Urge urinary incontinence (sudden involuntary loss of urine) 4, 5.
Treatment Options for OAB
- First-line treatment comprises conservative measures including weight reduction, a decrease in exposure to bladder stimulants, fluid optimization, and pelvic floor exercises 3.
- Pharmacological treatments for OAB include anticholinergic medications such as oxybutynin 3, 4.
- Bladder training is widely prescribed as a first-line treatment for OAB 6.
- Pelvic floor exercises, with or without biofeedback, electric stimulation, and behavioral modification, are excellent modalities that can be effective in the motivated patient 7.