Fast Five Quiz: Overactive Bladder Differential Diagnosis

Bradley Schwartz, DO


February 26, 2021

Figure 1. Overactive bladder. Coronal section through female bladder. Fat and peritoneum removed to show pelvic floor and pelvic splanchnic nerves.

A diagnosis of OAB depends on the presence of urgency, which differs from a simple urge to void. A typical urge to void is a normal sensation that progressively strengthens when deferred. In contrast, urgency is an abnormal condition characterized by a sudden onset of a desire to void that is difficult to defer.

Although nocturia is often assumed to be a symptom of OAB, not all patients with nocturia have OAB and the relationship between OAB and nocturia is not well understood. A 2011 consensus statement on the evaluation and treatment of nocturia concluded that most patients with nocturia do not have OAB, but most patients with OAB do have nocturia.

According to the 2019 guidelines of the American Urological Association (AUA) and the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU), OAB symptoms have four components: urgency, frequency, nocturia, and urgency incontinence. Neither pain upon urination nor abdominal discomfort is considered a hallmark symptom of OAB.

Learn more about OAB differential diagnosis.


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