Urinary urgency Sudden and urgent urge to urinate

This symptom consists of episodes of sudden and urgent urge to urinate, forming the basis of the overactive bladder syndrome.

These episodes can occur spontaneously or be triggered by some stimuli such as cold, touching water or even listening to the noise of running water or also in specific situations (such as when the patient is inserting the key in the house door or call the elevator). Although these stimuli may suggest that the problem is psychological, in reality what exists is a pathological process at the level of the bladder that is enhanced by these factors.

Urinary urgency is a symptom that can have a major impact on the quality of life of patients, especially when accompanied by loss of urine (urge urinary incontinence) - the patient feels an uncontrollable urge to go to urinate and cannot arrive on time to the toilet, and the loss may occur in large quantities.

Patients may develop a great fear that episodes will occur, and may avoid going to certain places where access to the bathroom may be more difficult. In addition, urinary urgency often leads the patient to abandon his personal, social or professional activities, which can be profoundly incapacitating (interrupting dinners, meetings, classes or having to leave the workplace multiple times).

The diagnosis is made using a bladder diary (voiding diary), sometimes complemented with a complete urodynamic study; further investigations to exclude underlying pathology that may be responsible for the symptoms (for example, bladder stones or tumors, in certain cases) may be indicated.

Some behavioral and conservative measures may reduce the impact and severity of urinary urgency as an essential symptom of an overactive bladder. When these fail, pharmacological or even surgical therapy may be indicated (such as intravesical injection of botulinum toxin or neuromodulation of sacred roots)