Monday, September 10, 2007

Overactive Bladder Part II

Overactive Bladder Stats: 21 million adults in US (10% of adult pop.) will have OAB-Dry, while 12 million adults in the US (6% of adult pop.) will have OAB-Wet.

OAB with or without incontinence can present coincidentally with Stress Incontinence- this is known as Mixed Incontinence.

OAB can be the result of:
Normal aging
Neurological causes
learned habit
overconsumption of fluids
pelvic trauma

Conditions that can be confused with OAB:

polyuria: large urine volume production
"irritable bladder syndrome"- food/caffiene/spice intolerance
interstitial cystitis
radiation cystitis
bladder tumor
bladder infection

An inventory of urinary symptoms and lifestyle as well as physical exam should be performed.
A "voiding diary" should be kept:

This is a log of how much fluid is consumed over 24-48 hours, in addition to the time and frequency of when an urge or leakage is experienced, as well as the volume of urine voided.

A urine analysis or blood and infection is performed usually.

residual urine can be checked as well.

1 comment:

icnjill said...

I wish that we had some true population based statistics that could differentiate between IC/OAB/PFD, etc.

In our experience, it seems as if many clinicians use OAB as a blanket term for most, if not all, ambiguous frequency/urgency patients. We often see patients labelled with IC who are the true "irritable bladder" patients who, once they modify their diet, improve and resolve quickly. Thus, did they have IC? Hard to say. Throw in a case of intractable IC patient who hasn't responded to any therapy and is scheduled for bladder removal only to discover that it was PFD rather than IC... it's clear that we need really GOOD and conclusive diagnostic criteria that can differentiate between all of the potential LUTS conditions! It's good to see another urology blogger out there!

Jill Osborne
Interstitial Cystitis Network