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The
International Continence Society (ICS) previously described
the overactive bladder as a disorder of bladder filling
and storage, in which involuntary bladder contractions
are demonstrated while the patient is attempting to inhibit
such contractions. If the patient is successful in inhibiting
the contractions, the patient will experience urinary
urgency without incontinence. If the patient cannot inhibit
the contractions, then urinary urgency and incontinence
will result (urge incontinence). Urinary frequency may
also be associated with this condition. |
Currently,
the International Continence Society 2002 edition of the Standardization
of Terminology of the Lower Urinary Tract Function describes
overactive bladder syndrome as urinary urgency with or without
urge incontinence, usually with frequency and nocturia, in
the absence of pathologic or metabolic conditions that might
explain these symptoms. Thus, a patient with diabetes may
have symptoms of overactive bladder, but does not have the
syndrome of overactive bladder. The syndrome of overactive
bladder is exclusive of any underlying metabolic or pathologic
conditions. This current definition of overactive bladder
attempts to define the condition by patient symptoms, rather
than urodynamic findings.
Stress
incontinence occurs through a different mechanism and is not
considered to be a component of the overactive bladder, though
some patients experience urinary incontinence from both mechanisms.
Patients who experience both stress and urge incontinence
are described as having mixed urinary incontinence.
If
the patient’s overactive bladder symptoms are the result
of a neurological condition, then the uninhibited bladder
contractions may be termed neurogenic detrusor overactivity
(previously termed detrusor hyperreflexia), implying a neurogenic
bladder. In many instances, the symptoms of overactive bladder
occur without any underlying neurological disorder. The involuntary
detrusor activity is then classified as idiopathic detrusor
overactivity (previously termed detrusor instability).
| The
most common symptoms of the overactive bladder are: |
 |
Urinary
urgency |
|
Frequency |
|
Nocturia |
|
Urge
incontinence |
These
symptoms, while relating to the overactive bladder, may have
origins in many different types of conditions.
|
