Symptoms and Diagnosis

Symptoms and diagnosis

Do you think you might have Overactive Bladder (OAB)?

Check out the list of symptoms below and discover how OAB can be correctly diagnosed.

If you have an overactive bladder you may experience a frequent, intense and urgent need to urinate. In some cases, it is so sudden that you have trouble making it to the bathroom in time. OAB is caused by involuntary bladder contractions and is characterised by a group of four symptoms:

Urgency

The most common symptom of overactive bladder is urinary urgency, which is a sudden and compelling desire to pass urine, which is difficult to hold in. Urgency may occur with accidental leakages, often referred to as “wet OAB” or without accidental leakage, often referred to as “dry OAB”.

Frequency

A person may visit the bathroom to urinate up to eight times in a 24-hour period. ⁷ However, if you find yourself going to the toilet more often than that, you may have OAB. Your bladder may feel extremely full, but you only pass a little urine. Sometimes, it may feel that your bladder has not completely emptied. It is possible to monitor the frequency of your toilet trips by keeping a bladder diary where you can record urination episodes.

Urge Incontinence

OAB can have symptoms of urinary urge incontinence. This happens because the sense of needing to empty your bladder is so overwhelming that there may be some accidental loss of urine before you reach the toilet. In urge incontinence, small or large quantities of urine can be lost involuntarily. Wearing pads is often not enough to cope with the large amounts of urine and frequent changes of clothes may be required. Activities are often planned around the availability of toilets and some people may restrict social activity outside the home for fear of leaking urine.

Nocturia

People with bladder problems may have night-time symptoms, which could indicate nocturia. Nocturia is defined as waking up two or more times a night to urinate. Most people can sleep for 6-8 hours without having to urinate. Nocturia can be very disruptive and lead to poor sleep quality, which can have a knock-on effect during the day.

Bladder Control Questionnaire

If you think you may be experiencing a bladder control problem, try the questionnaire.

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Diagnosis

OAB can be managed with the appropriate treatment. You should approach your GP to determine whether the symptoms you are experiencing are due to overactive bladder or another condition, and to decide which treatment is the best. The diagnosis of OAB is made primarily on the person's signs and symptoms and by ruling out other possible causes such as an infection.

The more information you have for the doctor about your symptoms, the more straightforward it will be to make a diagnosis. You may be asked to answer questions about patterns of passing urine; daily fluid intake; if you are taking any medications or supplements and to discuss any medical conditions you may have. Your doctor may conduct simple tests and possibly suggest that you keep a bladder diary recording your bathroom trips. A minority of people may require referral to a specialist for further tests. These may include urodynamic testing, which is usually carried out as an outpatient procedure in a hospital. Urodynamic ³ testing may involve measuring the pressure inside the bladder while the bladder is being filled.

Stress incontinence

Stress incontinence, notably different from OAB and urge incontinence is an accidental leakage of urine during physical activity or exertion, for example :

Coughing, laughing or sneezing
Exercising, particularly jumping
Lifting
In severe cases, getting out of bed, walking, or standing up

It is the most common form of urinary incontinence in women. Stress incontinence occurs when the muscles that control your urine flow become weak. ⁴ The pelvic floor muscles support the bladder and urethra (the tube that allows urine to pass from the bladder out of the body) and the urinary sphincter (a valve-like muscle around the opening of the bladder) squeezes to prevent urine from leaking through the urethra. Your pelvic floor muscles and urinary sphincter may lose strength because of childbirth (in women), injury to the urethra area, and surgery in the pelvic area or the prostate (in men). Stress incontinence problems in women may increase around the time of menopause and thereafter.