Diseases & Conditions >
This topic is from 5-Minute Urology Consult
Dr. Gomella's off-label usage statement   About our sources

Overactive Bladder (OAB) Updated 12/2009

Debra L. Fromer, MD, Daniel I. Brison, MD
Feedback Form
Email       Print Section  |  Print Topic       Add to My Favorites

BASICS

  • Description
  • Epidemiology
  • Risk Factors
  • General Prevention
  • Pathophysiology

DIAGNOSIS

  • Signs and Symptoms
  • Tests
  • Differential Diagnosis

TREATMENT

  • Medication (Drugs)
  • Surgery
  • Additional Treatment | Radiotherapy

Ongoing Care

  • Prognosis
  • Complications
The following is an excerpt....
BASICS
Description

A disorder during which patients experience urgency ± urge incontinence, usually accompanied by frequency and/or nocturia in the absence of causative infection or identified pathologic conditions

Epidemiology
  • ~16% of men and women over 40 suffer from OAB
  • In patients >75 yr, the prevalence increases to 31% of women and 42% of men.
Risk Factors
  • Caucasian
  • Insulin-dependent diabetes mellitus
  • Depression
  • Age >75
  • Arthritis
  • Increased BMI
General Prevention
  • High-fiber diet
  • Limited consumption of caffeine and alcohol
Pathophysiology

Overactivity of detrusor muscle:

  • Neurogenic (eg, MS, Parkinson disease, stroke, spinal cord lesions, trauma)
  • Myogenic (eg, aging, chronic bladder outlet obstruction, diabetes)
  • Idiopathic
  • Transient causes (DIAPPERS acronym):
    • Delirium
    • Infection
    • Atrophic urethritis/vaginitis
    • Pharmaceutical
    • Psychological
    • Excessive urine output
    • Restricted mobility
    • Stool impaction ...

You must be logged in to fully access this content.

View a sample algorithm for "Anemia"
Sign In
Forgot your password?
Sign up for a 30-Day Free Trial

Sign up for a 30-Day FREE Trial now and receive access to all content.

Start free trial!
Take a tour of 5MinuteConsult.com
Subscribe now to 5MinuteConsult

Have a book code?

Submit your book code to create your account.
See Also
Images >
1 2 3 4 5
View Large
Figure 29.5. Surgical therapy for urinary incontinence. (A1-A3) Anterior vaginal wall repair, the Kelly-Kennedy procedure. (A1) Anterior vaginal wall is opened and undermined. (A2) Paraurethral tissue lateral to the urethrovesical (UV) junction is sutured. (A3) This creates a firm bar of tissue that supports the UV junction. (B1-B4) Retropubic suspension procedures, the Marshall-Marchetti-Krantz procedure. (B1) The suture is placed in the periurethral tissue and then into the pubic periosteum so that (B2) the urethra may be advanced upward into an intra-abdominal position. (B3) The Burch procedure, by which the tissue adjacent to the UV angle is sutured to the iliopectineal (Coopers) ligament. (B4) The Richardson paravaginal repair, by which the sutures are placed between the superior sulcus of the vagina and lateral pelvic side wall at the level of the iliopectineal line. (C1-C3) Sling procedures. (C1) The Pereyra procedure, by which a needle is guided transabdominally into the paraurethral tissue and back through (C2) to be tied suprapubically, thus supporting the UV angle. (C3) The Stamey procedure, by which a Dacron support material is used in the paraurethral tissue to buttress the tissue. Credit: From Beckmann CRB M.D., M.H.P.E., Ling FW M.D., Laube DW M.D., M.ED., Smith RP M.D., Barzansky BM PH.D., M.H.P.E., and Herbert WNM.D.. Obstetrics and Gynecology, 4th Edition. Baltimore: Lippincott Williams & Wilkins, 2002.
Procedures & PT >