Overactive Bladder (OAB)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
- Overactive bladder (OAB) facts
- What is an overactive bladder?
- What are the causes of overactive bladder?
- Are there any risk factors for overactive bladder?
- What are overactive bladder symptoms?
- How do health-care professionals diagnose overactive bladder?
- What are the treatments for an overactive bladder?
- What is the role of medications in treating overactive bladder?
- Are there alternative therapies for OAB?
- What are treatments for the chronically incontinent?
- What measures can be taken at home to prevent overactive bladder symptoms?
- What are some of the complications of overactive bladder?
- What is the prognosis for overactive bladder?
- Find a local Urologist in your town
Overactive bladder (OAB) facts
- Overactive bladder is a syndrome (set of symptoms) that is thought to be due to sudden contractions of the muscle in the wall of the bladder.
- Overactive bladder can also result in urinary incontinence, otherwise termed urgency urinary incontinence (wet OAB).
- Overactive bladder is not a normal part of aging, but the risk of developing OAB increases with age.
- OAB affects both men and women and can significantly impact the quality of life.
- Many treatments are available for overactive bladder, including pelvic-muscle strengthening, behavioral therapies, medications, neuromodulation, and surgery.
What is an overactive bladder?
Overactive bladder (OAB) is a condition that is characterized by sudden, involuntary contraction of the muscle in the wall of the urinary bladder. This results in a sudden, compelling need to urinate that is difficult to suppress (urinary urgency), even though the bladder may only contain a small amount of urine. The key symptom is sudden urge to void (urgency) with or without urgency urinary incontinence, often associated with urinary frequency (voiding 8 or more times per day) and nocturia (awakening one or more times at night to void). Irritating fluids, such as caffeinated beverages (coffee, tea), spicy foods, and alcohol can worsen the symptoms. It is common for those affected to compensate for OAB by toilet mapping, fluid restriction, and timed voiding. There is no pain, burning, or blood in the urine with OAB.
Overactive bladder coupled with urinary leakage (inability to suppress the urge to void) is also referred to as urgency urinary incontinence. Another common type of urinary incontinence is called stress incontinence, which is caused by weakness in the pelvic floor muscles that surround and support the bladder and urethra. The symptom of stress incontinence is leakage when coughing, straining, jumping, or with other physical activity that increase the pressure in the abdomen (Valsalva). Treatment for stress incontinence is very different than urge incontinence. In some individuals, there can be a combination of urge and stress incontinence (mixed incontinence). Often, the most bothersome condition is treated first in individuals with mixed urinary incontinence. In general, urinary incontinence is more common in women compared to men.
|Symptoms||OAB||Stress Urinary Incontinence|
|Urgency (Strong, Sudden Desire to Void)||Yes||No|
|Frequency With Urgency (≥ 8 Times/24 Hours)||Yes||No|
|Leaking During Physical Activity (For Example, Coughing, Sneezing, Lifting)||No||Yes|
|Amounts of Urinary Leakage With Each Episode of Incontinence||Large (If Present)||Small|
|Ability to Reach the Toilet in Time Following Urge to Void||Often No||Yes|
|Nocturia (Waking to Pass Urine at Night)||Usually||Seldom|
The overall prevalence of overactive bladder is 13.9%, affecting men and women with equal frequency. Although it can happen at any age, overactive bladder is especially common in older adults. Overactive bladder should not be considered a normal part of aging. The prevalence under the age of 50 is < 10%. After age 60, the prevalence increases to 20%-30%. It is estimated that 60% of patients have dry OAB (no leakage) while 40% have wet OAB.
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