Overactive Bladder

Robert Sterling Hollabaugh, Jr. M.D., FACS

Overactive bladder (OAB) is a condition that affects approximately 33 million Americans. It can disrupt activities of daily life. The estimated economic impact of OAB in the U.S. exceeded $12 billion dollars in 2000. Women tend to be affected more commonly than men, and it occurs more frequently as people age.

The most common symptoms that suggest overactive bladder are:

  • Urinating frequently (more than 8 times) during the day (frequency)
  • Sudden strong urges to urinate (urgency)
  • Having to wake from sleep to urinate more than twice each night (nocturia)
  • Leaking urine before you get to the bathroom (urge incontinence)
  • Unconscious leakage of urine

Many other symptoms may accompany these, some of which deserve particular attention. If there is burning on urination, the possibility of urinary infection must be investigated with a urinalysis. Once an infection has been treated, any remaining symptoms should be re-evaluated. Many times, a urinary tract infection may have been causing all of the symptoms, mimicking an overactive bladder.

Blood in the urine (hematuria), whether visible or microscopically detected, needs to be further evaluated. The most common cause of blood in the urine is a urinary tract infection (UTI). Several weeks after treatment of the UTI the urine should be rechecked to see if any blood remains. If blood is still present, further evaluation will be recommended to exclude bladder cancer, kidney cancer, urinary stones, and urinary blockages as possible sources.

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