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| {{SignSymptom infobox |
| | #REDIRECT [[Urinary incontinence]] |
| Name = Overactive bladder |
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| ICD10 = N32.8 |
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| ICD9 = {{ICD9|596.51}} |
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| {{Search infobox}}
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| {{SCC}}
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| {{Editor Join}}
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| ==Overview==
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| '''Overactive bladder''' (OAB) is a urological condition defined by a set of symptoms: "urgency, with or without [[Urinary incontinence#Urge_incontinence_or_Hypertonic|urge incontinence]], usually with frequency and [[nocturia]]." The [http://www.icsoffice.org International Continence Society](ICS) is responsible for this definition. There exists, however, some controversy over the use of this term because these symptoms taken in isolation may overlap with those of other bladder conditions, including [[interstitial cystitis]], or rarely even bladder tumours.
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| ==Pathophysiology==
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| The [[etiology]] of OAB is unclear, and indeed there may be multiple possible causes. It is often associated with detrusor overactivity, a pattern of bladder muscle contraction observed during [[urodynamics]], and treatments for OAB, are usually synonymous with treatments for detrusor overactivity. OAB is distinct from [[Urinary incontinence#Stress_incontinence|stress urinary incontinence]], but when they occur together is usually known as mixed incontinence.
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| ==Epidemiology and demographics==
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| Earlier reports estimated that about one in six adults in the United States or Europe had OAB.<ref name="NOBLE survey">{{cite web|url=http://www.springerlink.com/content/604hqnbmmyh6r1ky/fulltext.pdf|title=Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, Hunt TL, Wein AJ. Prevalence and burden of overactive bladder in the United States ''World Journal of Urology'' 2003 May;20(6):327-36.}}</ref><ref name="Milsom et al 2001">
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| Milsom I, Abrams P, Cardozo L, Roberts RG, Thuroff J, Wein AJ. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. ''BJU Int.'' 2001 Jun;87(9):760-6.</ref> Because the average age of people in the developed world is increasing, it is expected that OAB will become more common in the future as the prevalence of OAB increases with age.<ref name="NOBLE survey">{{cite web|url=http://www.springerlink.com/content/604hqnbmmyh6r1ky/fulltext.pdf|title=Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, Hunt TL, Wein AJ. Prevalence and burden of overactive bladder in the United States ''World Journal of Urology'' 2003 May;20(6):327-36.}}</ref><ref name="Milsom et al 2001">
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| Milsom I, Abrams P, Cardozo L, Roberts RG, Thuroff J, Wein AJ. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. ''BJU Int.'' 2001 Jun;87(9):760-6.</ref> However, a recent Finnish population-based survey<ref name="Tikkinen et al 2007">{{cite web|url=http://www.plosone.org/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1371%2Fjournal.pone.0000195 |title=Tikkinen KAO, Tammela TLJ, Rissanen AM, Valpas A, Huhtala H, Auvinen A. Is the Prevalence of Overactive Bladder Overestimated? A Population-Based Study in Finland ''PLoS ONE'' 2007 2(2):e195.}}</ref> showed that the prevalence had been largely overestimated due to methodological shortcomings regarding age distribution and low participation (in earlier reports). OAB affects approximately half of that proposed earlier.<ref name="Tikkinen et al 2007">{{cite web|url=http://www.plosone.org/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1371%2Fjournal.pone.0000195 |title=Tikkinen KAO, Tammela TLJ, Rissanen AM, Valpas A, Huhtala H, Auvinen A. Is the Prevalence of Overactive Bladder Overestimated? A Population-Based Study in Finland ''PLoS ONE'' 2007 2(2):e195.}}</ref>
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| ==Treatment==
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| Treatment for OAB includes lifestyle modification (fluid restriction, avoidance of [[caffeine]]), bladder retraining, [[antimuscarinic]] drugs ([[darifenacin]], [[hyoscyamine]], [[oxybutynin]], [[tolterodine]], [[solifenacin]], [[trospium]]), and various devices ([[Percutaneous_Tibial_Nerve_Stimulation_(PTNS)|Urgent PC Neuromodulation System]], InterStim). Intravesical botulinum toxin A is also used in some intractable cases, although not with formal FDA approval. The antimuscarinic [[fesoterodine]] was recommended for approval by the [[European Medicines Agency]] in February 2007, and will become available for use during 2008.
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| ==References==
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| {{reflist}}
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| == Support Resources ==
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| *[http://www.incontact.org/ Incontact.org]
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| *[http://www.continence-foundation.org.uk/ The Continence Foundation]
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| *[http://www.cobfoundation.org/ Cystitis & Overactive Bladder Foundation - UK]
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| *[http://www.canadaic.com/ Canada IC & OAB Resource Center]
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| == Information Resources ==
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| *Overcoming Overactive Bladder
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| *Interstitial Cystitis Survival Guide
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| {{SIB}}
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| [[Category:Urology]]
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