Overactive bladder

Question 1

Definition

Answer 1

A frequent and sudden urge to urinate that may be difficult to control

Question 2

Aetiology/ causes

Answer 2

Involuntary contractions of the muscles of the bladder (even when the volume of urine is low)

^^ caused by neurological disorders, such as stroke and multiple sclerosis, diabetes, hormonal changes (menopause), tumors or bladder stones, enlarged prostate, constipation or previous surgery to treat incontinence

Question 3

Risk factors

Answer 3

Increased risk with diabetes, enlarged prostate

Cognitive decline (previous stroke or alzheimer’s)

Weak pelvic floor muscles

Excessive caffeine and alcohol intake

Obesity

Question 4

Epidemiology/ Population affected

Answer 4

Increased prevalence with increased age

Question 5

Clinical presentation

Answer 5

Feel a sudden urge to urinate that’s difficult to control

Urgency incontinence (lack of voluntary control)
Urinate frequently, usually eight or more times in 24 hours

Wake up more than two times in the night to urinate (nocturia)

Question 6

Prognosis

Answer 6

OAB will likely not subside/ will progress if left untreated, although there aren’t any major complications other than the reduced QOL associated with the symptoms.

Question 7

DDX

Answer 7

Stress incontinence
Functional incontinence
Overflow incontinence
Urinary fistula
Enuresis
Urinary tract infection
Diabetes
Bladder cancer
Bladder stones