Overactive bladder Bladder muscle hyperactivity

Overactive bladder syndrome is defined by the International Continence Society as corresponding to the sudden urge to urinate, with or without associated incontinence, usually with increased daytime and nighttime frequency.

This is a frequent situation, present in both sexes and tends to increase with age. It is not always understood by patients to be pathological, even though it has sometimes serious implications for their quality of life. Often patients become accustomed to urinating before leaving the house or to sit nearer the exit in public places, knowing that access to the bathroom may be more difficult.

In view of the presence of this type of symptoms, a careful and individualized analysis should be done with the objective of excluding possible identifiable causes for the clinical picture. When no justification for symptomatology is found, an overactive bladder syndrome may be effectively present, since the same clinical picture may arise in the context of other diseases and improve with the treatment of the disease that gave rise to the condition. The physiological basis for the occurrence of urgency episodes is usually detrusor overactivity, that is, the generation of involuntary contractions of the bladder muscle, which sends a signal to the brain creating a sense of urge to urinate. Urinary incontinence associated with detrusor contraction can sometimes occur.

The diagnosis of overactive bladder can be made based on the clinical history or require the completion of complementary diagnostic tests, namely the complete urodynamic study, in cases of diagnostic doubt or unsatisfactory response to the treatment instituted based on clinical data.

There are several therapies to apply depending on the clinical evaluation, from drug treatments, botulinum toxin bladder injections, PTNS or sacral root nerves neuromodulation.