Overactive Bladder

Overactive bladder (OAB) is a syndrome characterized by a sudden, involuntary contraction of the muscle in the wall of the urinary bladder, leading to urinary urgency, which is an immediate and strong need to urinate. This condition often occurs with frequency, which is the need to urinate more often than usual, and nocturia, which refers to waking up multiple times during the night to urinate. While not all persons with frequency and nocturia have OAB, these symptoms are commonly associated. Importantly, OAB can occur with or without urinary incontinence, the involuntary loss of urine, particularly noted as urgency incontinence.

From a physiological standpoint, the exact cause of OAB is not always clear, but it can be related to inappropriate signaling of the detrusor muscles that control bladder function. Contributing factors may include neurological disorders, bladder abnormalities, medications, or age-related changes. Diagnosis involves a thorough history, physical examination, urine tests, and sometimes neurologic tests or urodynamic evaluations to rule out other conditions. Management includes lifestyle modifications, pelvic floor muscle training, pharmacotherapy with antimuscarinics or beta-3 agonists, and in severe cases, surgical interventions or nerve stimulation therapies. The overall goal is to alleviate symptoms and improve quality of life for patients living with OAB.