How to diagnose overactive bladder (OAB)
In most cases, OAB can be diagnosed by clinical history, physical examination and urinalysis to rule out infection or blood in the urine.6
Signs and symptoms of OAB7
- Urinary urgency (hallmark symptom)
- Urge urinary incontinence (may or may not be present)
- Urinary frequency and nocturia (usually present)
Taking a careful clinical history is fundamental for diagnosis and should include details of the type, timing and severity of urinary incontinence (UI), associated voiding and other urinary symptoms. Patients should also be asked about any other health conditions and for details of current medications, as these may impact on their symptoms.6
This will then allow UI to be categorised into stress urinary incontinence (SUI), urgency urinary incontinence (UUI) or mixed urinary incontinence (MUI), and help identify those patients needing rapid referral to a specialist.6
In women, an obstetric and gynaecological history may help to understand the underlying cause of their UI and identify factors that may impact on treatment decisions.6
The physical assessment should include an abdominal examination to detect an enlarged bladder or other abdominal mass, and perineal and digital examination of the rectum (prostate) and/or vagina.6
Bladder diaries kept by the patient over a period of at least 3 days can play a valuable role in assessing the OAB symptoms, such as frequency of UI episodes. They can also be used to quantify urodynamic variables, such as voided volume and 24-hour or nocturnal total urine volume.6
Ultrasound is recommended for the assessment of post void residual urine volume. The use of imaging (i.e. magnetic resonance imaging, computed tomography and X-ray) is not recommended for the routine assessment of UI.6,8
Risk factors for OAB9
Risk factors for OAB may be modifiable or non-modifiable
Non-modifiable risk factors
- Age
- Sex
- Metabolic syndrome
- Post-menopausal
- Benign prostatic hyperplasia
- Pelvic organ prolapse in women
Modifiable risk factors
- Alcohol
- Smoking
- Obesity
- Caffeine
- Carbonated drinks
- Spicy foods
- Bladder stones
OAB: overactive bladder.
Please refer to the BOTOX® Summary of Product Characteristics for further information on adverse events, contraindications and special warnings and precautions for use.
Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk/
Adverse events should also be reported to AbbVie on GBPV@abbvie.com
Date of preparation: April 2024. UK-BUO-240024.
