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© The Canadian Journal of Urology™; 18(Supplement 1); April 2011
Address correspondence to Dr. Jack Barkin, Chief of Staff,
Humber River Regional Hospital, 960 LawrenceAvenueWest,
Suite 404, Toronto, Ontario M6A 3B5 Canada
Overactive bladder
Jack Barkin, MD
Humber River Regional Hospital, University of Toronto, Toronto, Ontario, Canada
BARKIN J. Overactive bladder. The Canadian
Journal of Urology. 2011;18(Supplement 1):8-13.
Overactive bladder (OAB) is common and has a negative
impact on a patient’s quality of life. It is important
for physicians to know how to identify and manage
patients with this condition. Usually only basic clinical
evaluations and a good patient history are necessary to
diagnose OAB. Effective and safe oral therapy is available
and can be initiated by primary care physicians.
Key Words:
overactive bladder, oral therapy
incontinence. Alarge national United States telephone
survey that was part of the National Overactive
Bladder Evaluation (NOBLE) program found that in
the general population, 16.9% of women had OAB --
9.3% with urge incontinence and 7.6% without urge
incontinence. The survey found that 16% of men had
OAB -- 2.4%with urge incontinence and 13.6%without
urge incontinence.
3
In Canada, it has been estimated
that OAB affects 12% to18% of the population, and, of
these individuals, one-third have wet OAB and two-
thirds have dry OAB.
4
The symptoms of OAB are similar to those of
lower urinary tract symptoms (LUTS), so to make
the diagnosis of pure OAB, physicians must rule out
other causes of the symptoms such as benign prostatic
hyperplasia (BPH) (inmen), urethral stricture, bladder
stone, atrophic vaginitis or vaginal prolapse (in
women), a neuropathic process, interstitial cystitis,
painful bladder syndrome, diabetes (or other causes
of polyuria), genitourinary malignancy, and urinary
tract infection.
Background
Overactive bladder (OAB) can be defined as urgency
with or without urge incontinence, generally
accompanied by frequency and nocturia.
1
Urgency,
which is usually the main presenting symptom, is
defined as a sudden, compelling desire to pass urine,
which is difficult to defer. Frequency is generally
defined as more than eight micturitions in a 24 hour
period, and nocturia is generally defined as more than
one micturition per night.
2
OAB may be classified as
“wet” (if it occurs with urge incontinence) or “dry”
(without urge incontinence).
The incidence and prevalence of OAB with or
without urge incontinence increases with increasing
age. While the prevalence of OAB is similar inmen and
women, men are less likely to have accompanying urge
8