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Symptoms of overactive bladder (OAB)

Urgency, frequency and nocturia are the three defining features of the overactive bladder (OAB) syndrome.

Urgency is the crucial and most bothersome symptom of the overactive bladder (OAB) that drives the other OAB symptoms.

Urgency - is defined as the sudden and compelling need to pass urine that is difficult to defer.

Urge incontinence- is the involuntary leakage of urine that is immediately preceded by urgency or occurs at the same time as urgency.

Frequency - is passing urine too many times while awake. This is a subjective problem and often associated with an increase in the number of times a person passes urine that often occurs gradually over time with OAB.

In many clinical trials studying OAB, frequency is arbitrarily defined as passing urine more than 8 times in a 24-hour period.

Nocturia - is waking at night due to the need to pass urine.

The symptoms of OAB are suggestive of detrusor (bladder muscle) overactivity. Detrusor overactivity means that the bladder muscle is contracting out of a person’s control usually at a lower than usual bladder volume and usually with little warning which gives rise to the symptom of urgency. The term OAB can only be used if other conditions such as infection or other bladder or pelvic pathology are excluded.

The majority of people with OAB are thought to have detrusor overactivity.

Detrusor overactivity is a diagnosis that is made after a special test called a urodynamic study. A urodynamic study does NOT need to be performed in all patients with OAB symptoms as the clinical diagnosis of OAB is based on a careful history, physical examination, bladder diary and basic investigations such as urine testing.