Overactive Bladder: What It Is, Causes, and Symptoms

Overactive bladder is a condition in which the bladder releases urine at an inappropriate moment. The symptoms of this disorder are widespread: up to 17% of the population of European countries and about 16% of US residents have symptoms. In terms of prevalence, the condition is comparable to hypertension, heart disease, asthma, and chronic bronchitis.

Overactive Bladder: What It Is

Overactive bladder (OAB), or hyperreflexic bladder, is a widespread disease. Its main symptom is urgency: a sudden strong urge to urinate, which may or may not be accompanied by involuntary leakage of urine. Urgency is often combined with frequent urination and nocturia—a predominance of nighttime trips to the toilet. The presence of signs of overactive bladder can be discussed with two or more symptoms: urination eight or more times per day or two or more times per night, a sudden strong need to urinate immediately, leakage of urine after such an urge.

How It Manifests: Symptoms and Urges

The clinical picture consists of urgency, frequent daytime and nighttime urination, and possible incontinence—loss of bladder control. Some patients deliberately increase the volume of fluid they drink, mistakenly believing that the cause of the urges is an infection; in such cases, regulating fluid intake often eliminates frequent urination. Consuming large amounts of caffeine-containing drinks—coffee, tea, some soft drinks—can provoke unbearable urges.

Causes of Overactive Bladder

The cause may be problems with the nerves, excess fluid, or excess caffeine; often the cause remains unknown. Some somatic diseases manifest with bladder overactivity: latent diabetes, multiple sclerosis, parkinsonism, lower urinary tract obstruction, dementia. A number of medications can provoke OAB or worsen patients' condition; among the most commonly used are diuretics and antihistamines.

How Overactive Bladder Differs from Infection

Complaints of urgency and frequent urination that arise suddenly against a background of full health are more likely a sign of lower urinary tract infection than a manifestation of bladder overactivity. To diagnose OAB, it is necessary to exclude other pathological conditions with similar symptoms: urinary tract infections, space-occupying lesions, bladder stones.

How Diagnostics Are Performed

Diagnosis of OAB, as a rule, does not present significant difficulties. When taking a history, attention is paid to the onset and duration of the disease, the intensity of urges, and the frequency of urination during the day and at night. The doctor may suggest keeping a diary in which the volume of fluid drunk and the frequency of urination are recorded, as well as performing an examination—gynecological or rectal. If necessary, the patient is referred to a specialist for additional tests.

When to See a Doctor

You should see a doctor for any type of urinary incontinence: this is a common problem, and talking about symptoms should not cause embarrassment. Consultation is the first step toward effective control of the condition. A small proportion of patients seek help, while the inability to control urination is so distressing that the condition is hidden even from close ones.

• Urination eight or more times per day or two or more times per night.
• A sudden strong urge to urinate immediately.
• Leakage of urine after a sudden strong urge.
• Loss of bladder control.

The condition itself is not a reason to call an ambulance; 103/112—for a life-threatening condition (for example, sudden severe pain, loss of consciousness, difficulty breathing).

This material is for reference: it describes the signs and scope of examination, but does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer