Overactive Bladder

Many people find their lives disrupted by the urge to urinate at inconvenient times and the loss of bladder control before making it to the bathroom.

Overactive bladder is a condition characterized by a sudden need to urinate with or without urine leakage. The cause of OAB is unknown. However, identifiable underlying causes can include: drug side effects, nerve damage or neurological disease (e.g., multiple sclerosis, Parkinson's disease, etc.) or stroke. There are also conditions that are associated with urgency and frequency - including bladder cancer, urinary tract infections and benign prostatic hyperplasia (BPH) - that must be ruled out during an examination.

Some evidence suggests that individuals with depression, anxiety and attention deficit disorder may experience symptoms more often than the general population.

One of the first steps toward diagnosing OAB is to keep a urination diary. Documenting symptoms, including urgency, can help your urologist make the proper diagnosis.

A urinalysis is performed to rule out infection and to look for glucose (sugar), blood, and white cells . After urination, residual urine is also checked using an ultrasound or catheterization. In some patients, a urine cytology or endoscopy (cystoscopy) of the bladder is warranted. It is sometimes useful to perform bladder pressure testing using cystometry (CMG) to document bladder (detrusor) overactivity during filling and exclude obstruction.

Treatment is often by administration of medications. In addition to drug therapies behavioral regimens have been shown to reduce incontinence and urinary frequency. Patients may want to change certain aspects of their diets ( decreasing caffeine or alcohol intake), lose weight and stop smoking.

Surgery to enlarge the bladder can be performed when the bladder is extremely small or generates high pressure. This is major surgery with potential complications and should be attempted as a last resort.