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Assessment of Overactive
Bladder
Diagnosis
Properly diagnosing OAB requires a detailed history of symptoms,
a thorough physical examination, and testing using many sophisticated
techniques, because many diseases can cause similar symptoms.
The following steps provide a quick reference for the assessment
of OAB:
- Patient history to determine the presence
of frequency, and
urgency, with or
without urge urinary incontinence
- Physical
examination to exclude anatomical, or neurological causes
- Urinalysis
to rule out an infectious cause
- Urinary diary to record symptoms,
fluid intake, time and volume of urine and any leakage of urine
for 1 to 7 days
- Urodynamic
tests when the diagnosis is unclear (e.g., ambulatory urodynamic
monitoring)– pressure changes must correspond with signs
and symptoms of OAB
Questions to Ask Your Patients
Key questions you can ask your patients during routine office visits
to
assist in screening for OAB include the following:
OAB Screening
Questions
- Do you leak urine when you cough, laugh, lift something
or sneeze? How often?
- Do you ever leak urine when you have a strong
urge on the way to the bathroom? How often?
- How frequently do you empty your bladder
during the day? Is it more than 8 times in 24 hours?
- How many times do you get up to urinate after going
to sleep? Is it the urge to urinate that wakes you?
- Do you ever
leak urine during sex?
- Do you wear pads to protect your clothes
from leaking urine? How often do you have to change them?
- Do
you frequently have a strong, sudden urge to urinate?
Voiding Diary
Voiding diaries,
or bladder diaries,
document the nature and severity of OAB symptoms as well as the
patient’s fluid intake. Information obtained from a voiding
diary includes total voiding volume, frequency of urination, and
distribution of urinations during the day and night. In addition,
the patient can grade the severity of his or her symptoms.
Here is an example of
a voiding diary:
Click below to download the voiding diary for your
patients.
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