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© The Canadian Journal of Urology™; 23(Supplement 1); February 2016
clinical investigations are similar in both genders
and should include a urinalysis, urine culture, serum
creatinine, post void residual (PVR) bladder volume
and a bladder diary. For the family physician, usually
that is all that is needed to initiate treatment. In males
however, extrameasuresmay need to be taken to assess
for bladder outlet obstruction. This may include a
pelvic ultrasound to assess PVR volume and prostate
size. For the urologist, a voiding flow rate study and
bladder scan PVR may be performed. Furthermore,
cystoscopy may be used to exclude anatomical causes
for symptoms such as urethral strictures ormalignancy.
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Gender differences in overactive bladder
Also in the realmof urologist is urodynamic testing,
which can be an important tool in the diagnosis of
OAB. Whilst not absolutely necessary before starting
conservative treatments andmedications, it can guide
management in patients with mixed symptoms,
unusual symptoms or in those who are failing first line
medical therapy. In male patients, it can differentiate
bladder outlet obstruction fromOAB or if they co-exist
and can help guide treatment and patient counseling.
Urodynamics is particularly important in patients
who have a suspicion of neurogenic DO, bladder
outlet obstruction or a possible urethral diverticulum
Figure 1.
Algorithm that offers a practical approach in evaluating the patient with symptoms consistent with
overactive bladder (OAB).
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