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Overactive bladder | |
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Other names | Overactive bladder syndrome |
Specialty | Urology |
Symptoms | Frequent feeling of needing to urinate, incontinence |
Complications | UTIs, anxiety |
Usual onset | More common with age[1] |
Duration | Chronic |
Types | Age-related, or Secondary to other illness |
Causes | Old age; detrusor muscle injury; over-consumption of water and caffeine; UTI; pelvic injury |
Risk factors | Old age, obesity, caffeine, constipation |
Diagnostic method | Based on symptoms after ruling out other possible causes[2][1] |
Differential diagnosis | Other neurological conditions[2][1] |
Treatment | Pelvic floor exercises, bladder training, drinking moderate fluids, weight loss,[3] medications, Botox, surgery |
Medication | Anticholinergic drugs, β3 agonists |
Prognosis | Often 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.[2] The frequent need to urinate may occur during the day, at night, or both.[4] Loss of bladder control (urge incontinence) may occur with this condition.[1] This condition is also sometimes characterized by a sudden and involuntary contraction of the bladder muscles, in response to excitement or anticipation. This in turn leads to a frequent and urgent need to urinate.
Overactive bladder affects approximately 11% of the population and more than 40% of people with overactive bladder have incontinence.[5][6] Conversely, about 40% to 70% of urinary incontinence is due to overactive bladder.[7] Overactive bladder is not life-threatening,[1] but most people with the condition have problems for years.[1]
The cause of overactive bladder is unknown.[1] Risk factors include obesity, caffeine, and constipation.[5] Poorly controlled diabetes, poor functional mobility, and chronic pelvic pain may worsen the symptoms.[1] People often have the symptoms for a long time before seeking treatment and the condition is sometimes identified by caregivers.[1] Diagnosis is based on a person's signs and symptoms and requires other problems such as urinary tract infections or neurological conditions to be excluded.[2][1] Uroflowmetry is also a good diagnostic aid.[8]
The amount of urine passed during each urination is relatively small.[1] Pain while urinating suggests that there is a problem other than overactive bladder.[1]
Specific treatment is not always required.[1] If treatment is desired pelvic floor exercises, bladder training, and other behavioral methods are initially recommended.[3] Weight loss in those who are overweight, decreasing caffeine consumption, and drinking moderate fluids, can also have benefits.[3] Medications, typically of the anti-muscarinic type, are only recommended if other measures are not effective.[3] They are no more effective than behavioral methods; however, they are associated with side effects, particularly in older people.[3][9] Some non-invasive electrical stimulation methods appear effective while they are in use.[10] Injections of botulinum toxin into the bladder is another option.[3] Urinary catheters or surgery are generally not recommended.[3] A diary to track problems can help determine whether treatments are working.[3]
Overactive bladder is estimated to occur in 7–27% of men and 9–43% of women.[1] It becomes more common with age.[1] Some studies suggest that the condition is more common in women, especially when associated with loss of bladder control.[1] Economic costs of overactive bladder were estimated in the United States at US$12.6 billion and 4.2 billion Euro in 2000.[11]