Materiały źródłowe

• #1 Overactive Bladder Syndrome: Evaluation and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5903463/

  Overactive bladder (OAB) syndrome is a chronic medical condition which has a major influence on the quality of life in a significant amount of the population. […] The definition of OAB updated in 2010 by the International Continence Society is: A condition with characteristic symptoms of urinary urgency, usually accompanied by frequency and nocturia, with or without urgency incontinence, in the absence of urinary tract infection or other obvious pathology. […] Diagnosis of OAB is considered in the absence of urinary tract infection, metabolic disorders (affecting urination), or urinary stress incontinence (generated by effort or overexertion). […] This review addresses various aspects of diagnosis and clinical management of the OAB syndrome. […] A bladder diary which describes the day-to-day bladder habits and patterns related to urination is the simplest and most important initial assessment tool.

• #2

  https://www.ics.org/committees/standardisation/terminologydiscussions/overactivebladder

  Overactive bladder syndrome (OAB) is defined as urinary urgency, usually with urinary frequency and nocturia, with or without urgency urinary incontinence. […] The diagnosis of OAB is made on the basis of symptoms alone. However, cystometry can be used to verify that uncontrolled contractions during bladder filling are responsible for the OAB symptoms. OAB is a symptom (complaint by the patient). DO is a diagnosis (confirmed by urodynamics). Nevertheless, it appears some practitioners consider OAB a diagnosis and treat it as if it were confirmed DO.

• #3 Overactive bladder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/overactive-bladder/diagnosis-treatment/drc-20355721

  If you have unusual urges to urinate, your healthcare professional checks for an infection or blood in your urine. Your health professional also may check to see if you’re emptying your bladder all the way when you urinate. […] Your appointment will likely include a: Medical history. Neurological exam to look for sensory issues or reflex problems. Physical exam, which may include a rectal exam and a pelvic exam in women. Urine sample to test for infection, traces of blood or other issues. […] Your health professional may suggest tests to see how well your bladder works and whether it can empty all the way, called urodynamic tests. A specialist most often does these tests. But testing may not be needed to make a diagnosis or begin treatment. […] Urodynamic tests include: Measuring urine left in the bladder. This test is important if you might not be emptying your bladder all the way when you urinate. Remaining urine in the bladder, called postvoid residual urine, can cause symptoms like those of an overactive bladder.

• #4 The AUA/SUFU Guideline on the Diagnosis and Treatment of Idiopathic Overactive Bladder – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/idiopathic-overactive-bladder

  In the initial office evaluation of patients presenting with symptoms suggestive of OAB, clinicians should: obtain a medical history with comprehensive assessment of bladder symptoms, conduct a physical examination, and perform a urinalysis to exclude microhematuria and infection. (Clinical Principle) […] Clinicians may offer telemedicine to initially evaluate patients with symptoms suggestive of OAB, with the understanding that a physical exam will not be performed and urinalysis should be obtained at a local laboratory (or recent lab results reviewed, if available). (Expert Opinion) […] Clinicians may obtain a post-void residual in patients with symptoms suggestive of OAB to exclude incomplete emptying or urinary retention, especially in patients with concomitant voiding or emptying symptoms. (Clinical Principle)

• #5 OAB Diagnosis – Voices for PFD

  https://www.voicesforpfd.org/bladder-control/oab-diagnosis/

  Diagnosis of Overactive bladder/Urgency Urinary Incontinence will start with a thorough medical history. Your doctor will obtain a history of how often you urinate during the day and night and if you have an abnormal strong urge to urinate. Other important information is if you are leaking with urgency, at night and/or without any sensation. Documentation of pad use is also recorded. […] A physical exam will be performed with attention to the abdomen and genital areas for assessment of anatomy and signs of possible pelvic organ prolapse. […] A urine sample is important to rule out a bladder infection. Your doctor may also check to make sure you are emptying your bladder. This can be done by either an ultrasound scan of the bladder or by passing a small catheter into the bladder to drain the remaining urine after voiding.

• #6 Diagnosing Overactive Bladder

  https://www.webmd.com/urinary-incontinence-oab/overactive-bladder-making-diagnosis

  To get a diagnosis of overactive bladder, your doctor starts with a complete health history to learn about other urinary conditions you’ve had in the past, and when the problem started. Your doctor will examine you, ask questions, and perform tests. […] Keeping an OAB diary at home can help you answer these questions and help with an overactive bladder diagnosis. Each day, write down how much you drink, when you urinate, how much you urinate each time, and whether you ever feel an urgent need to go. […] There are a number of tests for overactive bladder, depending on your health history and symptoms. For these tests, you’ll likely see a urologist (a doctor who is trained to treat urinary disorders). If you’re a woman, you can also visit a urogynecologist. […] Tests for overactive bladder include:

• #7 Overactive bladder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/overactive-bladder/diagnosis-treatment/drc-20355721

  If you have unusual urges to urinate, your healthcare professional checks for an infection or blood in your urine. Your health professional also may check to see if you’re emptying your bladder all the way when you urinate. […] Your appointment will likely include a: Medical history. Neurological exam to look for sensory issues or reflex problems. Physical exam, which may include a rectal exam and a pelvic exam in women. Urine sample to test for infection, traces of blood or other issues. […] Your health professional may suggest tests to see how well your bladder works and whether it can empty all the way, called urodynamic tests. A specialist most often does these tests. But testing may not be needed to make a diagnosis or begin treatment. […] Urodynamic tests include: Measuring urine left in the bladder. This test is important if you might not be emptying your bladder all the way when you urinate. Remaining urine in the bladder, called postvoid residual urine, can cause symptoms like those of an overactive bladder.

• #8 Overactive bladder: Diagnosis and treatment – Medical Independent

  https://www.medicalindependent.ie/clinical-news/overactive-bladder-diagnosis-and-treatment/

  Overactive bladder (OAB) syndrome is a chronic disabling condition that significantly reduces the quality-of-life of millions of people worldwide. […] The diagnosis of OAB can be challenging due to the lack of a specific diagnostic test and the overlap of symptoms with other lower urinary tract disorders. […] The evaluation of OAB should include a detailed medical history, physical examination, and laboratory tests to exclude other causes of lower urinary tract symptoms (LUTS) such as UTI, bladder stones, or malignancy. […] A detailed medical history can highlight possible risk factors for OAB. […] Examination should include assessment of urinary, gynaecological, and neurological systems. […] A voiding diary is a useful tool for assessing the frequency and volume of voids, urgency, and episodes of urge incontinence. […] Cystoscopy and urodynamics are usually not necessary for the diagnosis of OAB, but may be helpful in selected cases, such as when there is suspicion of bladder outlet obstruction or neurogenic bladder.

• #9 Diagnosis of Overactive Bladder – ROC Clinic

  https://rocclinic.com/en/overactive-bladder/diagnosis/

  Any other disease must be ruled out before an overactive bladder can be correctly diagnosed. […] Overactive bladder is characterized by the presence of urinary urgency – with or without urinary incontinence – associated with increased daytime and nighttime frequency of urination. For its diagnosis, the physician must document all the symptoms and signs presented by the patient and exclude the existence of other pathologies that could cause the symptoms. […] Initial evaluation of patients with overactive bladder should include: […] Medical history: It is essential in the initial evaluation and should collect the type, time and severity of symptoms, as well as the presence or absence of urinary incontinence. […] Physical examination: It includes abdominal examination to detect increased bladder volume or the presence of other abdominal masses.

• #10 Overactive Bladder Syndrome: Evaluation and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5903463/

  Several laboratory tests are recommended in the evaluation of OAB: urine analysis, urinary culture, and blood tests to determine the levels of glycozilated hemoglobin (HbA1C), electrolytes, and levels of creatinine for kidney function evaluation. […] The European Association of Urology and the Japanese Urological Society recommend non-pharmacological and pharmacological treatments for OAB. […] The aim of non-pharmacological treatment is to educate patients about OAB and help them to develop strategies to manage urge and urge incontinence. […] The state of the art pharmacological treatment for OAB is the use of anticholinergic (also called antimuscarinics) drugs. […] Several reviews of randomized trials concluded that antimuscarinic drugs produced a significant improvement or cure. […] Failure in achieving clinical improvement with anti-muscarinic drugs is problematic for the patient and challenging for the physician.

• #11 The AUA/SUFU Guideline on the Diagnosis and Treatment of Idiopathic Overactive Bladder – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/idiopathic-overactive-bladder

  Clinicians may obtain a symptom questionnaire and/or a voiding diary in patients with symptoms suggestive of OAB to assist in the diagnosis of OAB, exclude other disorders, ascertain the degree of bother, and/or evaluate treatment response. (Clinical Principle) […] Clinicians should not routinely perform urodynamics, cystoscopy, or urinary tract imaging in the initial evaluation of patients with OAB. (Clinical Principle) […] Clinicians may perform advanced testing, such as urodynamics, cystoscopy, or urinary tract imaging in the initial evaluation of patients with OAB when diagnostic uncertainty exists. (Clinical Principle) […] Clinicians should assess for comorbid conditions in patients with OAB that may contribute to urinary frequency, urgency, and/or urgency urinary incontinence and should educate patients on the role that managing these conditions can have on bladder symptoms. (Expert Opinion)

• #12 Diagnosing Overactive Bladder

  https://www.webmd.com/urinary-incontinence-oab/overactive-bladder-making-diagnosis

  Urinalysis. Taking a urine sample allows your doctor to check for conditions that can cause overactive bladder. […] Postvoid residual volume. This test checks to see whether the bladder empties fully by passing a flexible tube called a catheter through your urethra and into your bladder after you’ve urinated. […] Bladder stress test. To see whether you’re leaking urine, your doctor might do a bladder stress test, which consists of filling your bladder with fluid and then asking you to cough. […] Ultrasound. This test uses sound waves to visualize the bladder and other parts of the urinary tract. […] Cystoscopy. This test uses a thin, lighted instrument called a cystoscope to visualize the inside of the urethra and bladder. […] Urodynamic testing. This series of tests measures how well your bladder holds and empties urine. […] These OAB tests can help diagnose whether your condition has something to do with an infection or other illness, a blockage, or poorly functioning bladder muscles. Knowing the cause of your overactive bladder can help your doctor find the right treatment for you.

• #13 Clinical testing for overactive bladder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3193395/

  While the diagnosis of overactive bladder (OAB) is made clinically, simple office testing (e.g., urinalysis and culture, assessment of post-void residual urine) should be part of the work-up of all patients with these symptoms. […] The diagnosis of overactive bladder (OAB) is a clinical one, based on the presence of urgency, with or without incontinence, usually with frequency and nocturia in the absence of an underlying metabolic or pathologic condition. […] Simple office testing should also be a part of the initial assessment and work-up, including urinalysis and culture and assessment of post-void residual urine. […] Supplemental testing should be considered for patients in whom the simple evaluation described above raises suspicion of a problem or condition that either needs evaluation or may predispose the patient to failure of therapy.

• #14 Overactive bladder syndrome: an overview of diagnosis and management | Nursing Times

  https://www.nursingtimes.net/bladder-and-bowel/overactive-bladder-syndrome-an-overview-of-diagnosis-and-management-30-05-2022/

  Overactive bladder syndrome is a common condition in which no cause can be found for repeated and uncontrolled bladder symptoms. This article discusses diagnosis and management options […] The diagnosis of overactive bladder syndrome is based on symptoms. The first step in the assessment process is to take a thorough clinical history of the type, onset and severity of the patients symptoms and their impact on quality of life. […] Urinalysis should be performed to screen for blood, glucose and protein. Dipstick tests that are negative for nitrite and leukocyte esterase can reliably exclude most urinary tract infections. […] To ascertain the severity and impact of the patients symptoms, a validated quality-of-life questionnaire should be used, such as the International Consultation on Incontinence Questionnaire Overactive Bladder Module.

• #15 Overactive Bladder Syndrome: Evaluation and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5903463/

  Overactive bladder (OAB) syndrome is a chronic medical condition which has a major influence on the quality of life in a significant amount of the population. […] The definition of OAB updated in 2010 by the International Continence Society is: A condition with characteristic symptoms of urinary urgency, usually accompanied by frequency and nocturia, with or without urgency incontinence, in the absence of urinary tract infection or other obvious pathology. […] Diagnosis of OAB is considered in the absence of urinary tract infection, metabolic disorders (affecting urination), or urinary stress incontinence (generated by effort or overexertion). […] This review addresses various aspects of diagnosis and clinical management of the OAB syndrome. […] A bladder diary which describes the day-to-day bladder habits and patterns related to urination is the simplest and most important initial assessment tool.

• #16 Diagnosing Overactive Bladder

  https://www.webmd.com/urinary-incontinence-oab/overactive-bladder-making-diagnosis

  To get a diagnosis of overactive bladder, your doctor starts with a complete health history to learn about other urinary conditions you’ve had in the past, and when the problem started. Your doctor will examine you, ask questions, and perform tests. […] Keeping an OAB diary at home can help you answer these questions and help with an overactive bladder diagnosis. Each day, write down how much you drink, when you urinate, how much you urinate each time, and whether you ever feel an urgent need to go. […] There are a number of tests for overactive bladder, depending on your health history and symptoms. For these tests, you’ll likely see a urologist (a doctor who is trained to treat urinary disorders). If you’re a woman, you can also visit a urogynecologist. […] Tests for overactive bladder include:

• #17 Overactive Bladder in Women | Gynecology | Henry Ford Health – Detroit, MI

  https://www.henryford.com/services/gynecology/pelvic-disorders/overactive-bladder

  Overactive bladder diagnosis […] To accurately diagnosis OAB, your doctor may recommend one of more of these tools: […] Bladder diary: If you suspect you have overactive bladder, your doctor may ask you to keep a bladder diary. This can pinpoint possible triggers and help determine the best treatment. Youll record: What you drink and when, When and how much you urinate, Any times you leak or have an accident, What you were doing when the leaks occurred […] […] Urinalysis: We analyze a sample of your urine to check for signs of infection and how well your kidneys are functioning. […] Bladder ultrasound: We use ultrasound to see inside the bladder and analyze how much urine remains after urination. […] Bladder pressure testing: We use this test to measure the strength and activity of the detrusor muscle.

• #18 Overactive bladder syndrome Management and treatment options

  https://www.racgp.org.au/afp/2012/november/overactive-bladder-syndrome

  A frequency/volume chart can exclude 24-hour polyuria due to diabetes insipidus, and nocturnal polyuria. It is an invaluable tool in OBS as it gives a better picture of the pattern of voiding than can be obtained from the symptoms alone. […] Secondary investigations should be considered in patients with neurological disease, refractory OBS, or those in whom initial investigations raise the suspicion of an underlying problem that may require further evaluation or treatment. […] Urodynamic testing aims to demonstrate incontinence objectively and differentiate between different types of incontinence, so that the most effective method of treatment can be selected. […] Urine cytology, performed on three voided specimens obtained on three separate days, has a variable sensitivity for the detection of urothelial carcinoma. […] Cystoscopy is indicated in patients with sterile haematuria and risk factors for bladder cancer, and in patients with recurrent urinary tract infections.

• #19 Overactive bladder syndrome Management and treatment options

  https://www.racgp.org.au/afp/2012/november/overactive-bladder-syndrome

  A frequency/volume chart can exclude 24-hour polyuria due to diabetes insipidus, and nocturnal polyuria. It is an invaluable tool in OBS as it gives a better picture of the pattern of voiding than can be obtained from the symptoms alone. […] Secondary investigations should be considered in patients with neurological disease, refractory OBS, or those in whom initial investigations raise the suspicion of an underlying problem that may require further evaluation or treatment. […] Urodynamic testing aims to demonstrate incontinence objectively and differentiate between different types of incontinence, so that the most effective method of treatment can be selected. […] Urine cytology, performed on three voided specimens obtained on three separate days, has a variable sensitivity for the detection of urothelial carcinoma. […] Cystoscopy is indicated in patients with sterile haematuria and risk factors for bladder cancer, and in patients with recurrent urinary tract infections.

• #20 Overactive bladder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/overactive-bladder/diagnosis-treatment/drc-20355721

  If you have unusual urges to urinate, your healthcare professional checks for an infection or blood in your urine. Your health professional also may check to see if you’re emptying your bladder all the way when you urinate. […] Your appointment will likely include a: Medical history. Neurological exam to look for sensory issues or reflex problems. Physical exam, which may include a rectal exam and a pelvic exam in women. Urine sample to test for infection, traces of blood or other issues. […] Your health professional may suggest tests to see how well your bladder works and whether it can empty all the way, called urodynamic tests. A specialist most often does these tests. But testing may not be needed to make a diagnosis or begin treatment. […] Urodynamic tests include: Measuring urine left in the bladder. This test is important if you might not be emptying your bladder all the way when you urinate. Remaining urine in the bladder, called postvoid residual urine, can cause symptoms like those of an overactive bladder.

• #21 Overactive bladder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/overactive-bladder/diagnosis-treatment/drc-20355721

  If you have unusual urges to urinate, your healthcare professional checks for an infection or blood in your urine. Your health professional also may check to see if you’re emptying your bladder all the way when you urinate. […] Your appointment will likely include a: Medical history. Neurological exam to look for sensory issues or reflex problems. Physical exam, which may include a rectal exam and a pelvic exam in women. Urine sample to test for infection, traces of blood or other issues. […] Your health professional may suggest tests to see how well your bladder works and whether it can empty all the way, called urodynamic tests. A specialist most often does these tests. But testing may not be needed to make a diagnosis or begin treatment. […] Urodynamic tests include: Measuring urine left in the bladder. This test is important if you might not be emptying your bladder all the way when you urinate. Remaining urine in the bladder, called postvoid residual urine, can cause symptoms like those of an overactive bladder.

• #22 Overactive bladder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/overactive-bladder/diagnosis-treatment/drc-20355721

  To measure residual urine after you void, your health professional may want an ultrasound scan of your bladder. The ultrasound scan translates sound waves into an image. The image shows how much urine is left in your bladder after you urinate. […] Sometimes, a thin tube, called a catheter, is passed through the urethra and into your bladder to drain the remaining urine. Then the urine can be measured. […] Measuring urine flow rate. To measure how much and how fast you urinate, you may be asked to urinate into a device called a uroflowmeter. A uroflowmeter catches and measures the urine. It then uses the data to create a graph of changes in your flow rate. […] Testing bladder pressures. A test called cystometry measures pressure in your bladder and in the area around it as your bladder fills. After emptying your bladder with a thin tube called a catheter, your health professional uses another catheter to fill your bladder slowly with warm fluid. […] Your health provider reviews the results of your tests with you and suggests a treatment plan.

• #23 Overactive bladder syndrome Management and treatment options

  https://www.racgp.org.au/afp/2012/november/overactive-bladder-syndrome

  Overactive bladder syndrome is a diagnosis of exclusion. A focused history, including past history of urogenital disorders, in combination with physical examination of the genitourinary system and relevant pelvic examinations should be performed as there are multiple conditions that can cause or contribute to symptoms of overactive bladder. […] Initial and secondary investigations are listed in Table 2. […] Postvoid residual volume (PVR) is best measured with ultrasound (bladder scan or formal ultrasound), with the upper limit of normal being 30 mL. An initially raised PVR requires confirmation before being considered significant as it can be subject to error. […] Increased PVR may contribute to urinary frequency and nocturia, and commencing anticholinergic medications in a patient with increased PVR may worsen bladder function and potentiate urinary retention.

• #24 Overactive bladder syndrome Management and treatment options

  https://www.racgp.org.au/afp/2012/november/overactive-bladder-syndrome

  Overactive bladder syndrome is a diagnosis of exclusion. A focused history, including past history of urogenital disorders, in combination with physical examination of the genitourinary system and relevant pelvic examinations should be performed as there are multiple conditions that can cause or contribute to symptoms of overactive bladder. […] Initial and secondary investigations are listed in Table 2. […] Postvoid residual volume (PVR) is best measured with ultrasound (bladder scan or formal ultrasound), with the upper limit of normal being 30 mL. An initially raised PVR requires confirmation before being considered significant as it can be subject to error. […] Increased PVR may contribute to urinary frequency and nocturia, and commencing anticholinergic medications in a patient with increased PVR may worsen bladder function and potentiate urinary retention.

• #25 Overactive bladder syndrome Management and treatment options

  https://www.racgp.org.au/afp/2012/november/overactive-bladder-syndrome

  Overactive bladder syndrome is a diagnosis of exclusion. A focused history, including past history of urogenital disorders, in combination with physical examination of the genitourinary system and relevant pelvic examinations should be performed as there are multiple conditions that can cause or contribute to symptoms of overactive bladder. […] Initial and secondary investigations are listed in Table 2. […] Postvoid residual volume (PVR) is best measured with ultrasound (bladder scan or formal ultrasound), with the upper limit of normal being 30 mL. An initially raised PVR requires confirmation before being considered significant as it can be subject to error. […] Increased PVR may contribute to urinary frequency and nocturia, and commencing anticholinergic medications in a patient with increased PVR may worsen bladder function and potentiate urinary retention.

• #26 Overactive bladder syndrome: an overview of diagnosis and management | Nursing Times

  https://www.nursingtimes.net/bladder-and-bowel/overactive-bladder-syndrome-an-overview-of-diagnosis-and-management-30-05-2022/

  Overactive bladder syndrome is a common condition in which no cause can be found for repeated and uncontrolled bladder symptoms. This article discusses diagnosis and management options […] The diagnosis of overactive bladder syndrome is based on symptoms. The first step in the assessment process is to take a thorough clinical history of the type, onset and severity of the patients symptoms and their impact on quality of life. […] Urinalysis should be performed to screen for blood, glucose and protein. Dipstick tests that are negative for nitrite and leukocyte esterase can reliably exclude most urinary tract infections. […] To ascertain the severity and impact of the patients symptoms, a validated quality-of-life questionnaire should be used, such as the International Consultation on Incontinence Questionnaire Overactive Bladder Module.

• #27 Overactive bladder syndrome: Management and treatment options

  https://www1.racgp.org.au/ajgp/2020/september/overactive-bladder-syndrome

  Overactive bladder (OAB) is a diagnosis of exclusion that begins with a targeted history and examination of the urogenital system with the aim of assessing the burden of disease on the patient. […] OAB is a diagnosis of exclusion beginning with a targeted history and examination of the urogenital system with an aim to assess the burden of disease facing the patient and affecting their quality of life (refer to Table 2). […] It is important to complete comprehensive history-taking, assessing pertinent past medical history, quantification of local symptoms, urge incontinence and obstetric history. Specific details of incontinence should be interrogated to exclude other types of incontinence. Use of validated questionnaires such as the OAB questionnaire (OAB-q) to assess patient quality of life with urge incontinence, or the International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQOAB) to assess severity and burden assist in providing a baseline from which treatment efficacy can be determined.

• #28 Overactive bladder syndrome: Management and treatment options

  https://www1.racgp.org.au/ajgp/2020/september/overactive-bladder-syndrome

  Overactive bladder (OAB) is a diagnosis of exclusion that begins with a targeted history and examination of the urogenital system with the aim of assessing the burden of disease on the patient. […] OAB is a diagnosis of exclusion beginning with a targeted history and examination of the urogenital system with an aim to assess the burden of disease facing the patient and affecting their quality of life (refer to Table 2). […] It is important to complete comprehensive history-taking, assessing pertinent past medical history, quantification of local symptoms, urge incontinence and obstetric history. Specific details of incontinence should be interrogated to exclude other types of incontinence. Use of validated questionnaires such as the OAB questionnaire (OAB-q) to assess patient quality of life with urge incontinence, or the International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQOAB) to assess severity and burden assist in providing a baseline from which treatment efficacy can be determined.

• #29 Overactive bladder – Wikipedia

  https://en.wikipedia.org/wiki/Overactive_bladder

  Diagnosis of OAB is made primarily on the person’s signs and symptoms and by ruling out other possible causes such as an infection. […] Urodynamics, a bladder scope, and ultrasound are generally not needed. […] Additionally, urine culture may be done to rule out infection. The frequency/volume chart may be maintained and cystourethroscopy may be done to exclude tumor and kidney stones. […] Psychometrically robust self-completion questionnaires are generally recognized as a valid way of measuring a person’s signs and symptoms, but there does not exist a single ideal questionnaire. […] These surveys can be divided into two groups: general surveys of lower urinary tract symptoms and surveys specific to overactive bladder. […] OAB causes similar symptoms to some other conditions such as urinary tract infection (UTI), bladder cancer, and benign prostatic hyperplasia (BPH).

• #30 Overactive bladder syndrome: Management and treatment options

  https://www1.racgp.org.au/ajgp/2020/september/overactive-bladder-syndrome

  Overactive bladder (OAB) is a diagnosis of exclusion that begins with a targeted history and examination of the urogenital system with the aim of assessing the burden of disease on the patient. […] OAB is a diagnosis of exclusion beginning with a targeted history and examination of the urogenital system with an aim to assess the burden of disease facing the patient and affecting their quality of life (refer to Table 2). […] It is important to complete comprehensive history-taking, assessing pertinent past medical history, quantification of local symptoms, urge incontinence and obstetric history. Specific details of incontinence should be interrogated to exclude other types of incontinence. Use of validated questionnaires such as the OAB questionnaire (OAB-q) to assess patient quality of life with urge incontinence, or the International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQOAB) to assess severity and burden assist in providing a baseline from which treatment efficacy can be determined.

• #31 Clinical testing for overactive bladder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3193395/

  The rationale for supplemental testing prior to second-line therapies for OAB has to do with the fact that these therapies may be either invasive, expensive, or have significant side effects. […] Comprehensive urodynamic testing goes beyond the detection and documentation of detrusor overactivity. […] Endoscopic evaluation of the lower urinary tract can identify a number of potential underlying causes of the OAB symptomatology. […] In most cases a good history, physical examination, PVR and voiding diaries (if obtainable) are all that is necessary to initiate treatment of OAB. Further testing is most useful for patients with neurological disease, refractory OAB, or those in whom simple evaluation raises suspicion of an underlying urological or non-urological problem that may require further evaluation or treatment.

• #32 Overactive bladder syndrome Management and treatment options

  https://www.racgp.org.au/afp/2012/november/overactive-bladder-syndrome

  A frequency/volume chart can exclude 24-hour polyuria due to diabetes insipidus, and nocturnal polyuria. It is an invaluable tool in OBS as it gives a better picture of the pattern of voiding than can be obtained from the symptoms alone. […] Secondary investigations should be considered in patients with neurological disease, refractory OBS, or those in whom initial investigations raise the suspicion of an underlying problem that may require further evaluation or treatment. […] Urodynamic testing aims to demonstrate incontinence objectively and differentiate between different types of incontinence, so that the most effective method of treatment can be selected. […] Urine cytology, performed on three voided specimens obtained on three separate days, has a variable sensitivity for the detection of urothelial carcinoma. […] Cystoscopy is indicated in patients with sterile haematuria and risk factors for bladder cancer, and in patients with recurrent urinary tract infections.

• #33 Overactive Bladder Testing & Diagnosis – Top Chicago Urologists

  https://auspecialists.com/overactive-bladder-testing-diagnosis/

  A number of tests may be performed during or after your visit, depending on the patients history and evaluation. […] Urodynamics is the gold standard test to evaluate for overactive bladder. This is a minimally invasive test that takes only 5-10 minutes where a small catheter is placed in the bladder and the bladder is then filled. The pressure in the bladder is measured during filling and pressure increases (involuntary contractions) during filling are the hallmark of an overactive bladder. […] The diagnosis of overactive bladder (OAB) is primarily done by a thorough medical history and possibly one or more tests to help measure the severity of a bladders dysfunction. […] All of the information from your history and any tests performed will be used to make an accurate diagnosis and to help develop a treatment plan that is right for you. […] Overactive bladder (OAB) testing and diagnosis can be performed quickly at any of our AUS offices.

• #34 Overactive Bladder Workup: Approach Considerations, Urine Studies, Postvoid Residual Testing

  https://emedicine.medscape.com/article/459340-workup

  Urodynamic study, cystoscopy, and diagnostic renal and bladder ultrasonography are not necessary in the initial workup of uncomplicated cases and should be reserved for refractory or otherwise complicated cases. […] Urine cytology is not recommended in the absence of hematuria when the patient responds to therapy. […] Postvoid residual testing is not indicated in all patients. It is helpful in men with both obstructive and OAB symptoms and in women who have undergone prior pelvic surgery (eg, prior incontinence surgery) and those with significant pelvic organ prolapse. […] A urodynamic study is not indicated as part of the first-line evaluation of patients with OAB unless a neurologic etiology is suspected. […] Examination of the bladder lining and the urethra with cystoscopy may be useful in patients with refractory or otherwise complicated OAB.

• #35 Overactive Bladder Workup: Approach Considerations, Urine Studies, Postvoid Residual Testing

  https://emedicine.medscape.com/article/459340-workup

  Urodynamic study, cystoscopy, and diagnostic renal and bladder ultrasonography are not necessary in the initial workup of uncomplicated cases and should be reserved for refractory or otherwise complicated cases. […] Urine cytology is not recommended in the absence of hematuria when the patient responds to therapy. […] Postvoid residual testing is not indicated in all patients. It is helpful in men with both obstructive and OAB symptoms and in women who have undergone prior pelvic surgery (eg, prior incontinence surgery) and those with significant pelvic organ prolapse. […] A urodynamic study is not indicated as part of the first-line evaluation of patients with OAB unless a neurologic etiology is suspected. […] Examination of the bladder lining and the urethra with cystoscopy may be useful in patients with refractory or otherwise complicated OAB.

• #36 The AUA/SUFU Guideline on the Diagnosis and Treatment of Idiopathic Overactive Bladder – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/idiopathic-overactive-bladder

  Clinicians may perform urodynamics in patients with OAB who do not adequately respond to pharmacotherapy or minimally invasive therapies or procedures to further evaluate bladder function and exclude other disorders. (Clinical Principle) […] The clinician may offer bladder augmentation cystoplasty or urinary diversion in severely impacted patients with OAB who have not responded to all other therapeutic options. (Expert Opinion) […] Clinicians should only recommend chronic indwelling urethral or suprapubic catheters to patients with OAB when OAB therapies are contraindicated, ineffective, or no longer desired by the patient and always in the context of shared decision-making due to risk of harm. (Expert Opinion) […] Clinicians may offer patients with BPH and bothersome OAB, in the context of shared decision-making, initial management with non-invasive therapies, pharmacotherapy, or minimally invasive therapies. (Expert Opinion) […] Clinicians may offer patients BPH and OAB monotherapy with antimuscarinic medications or beta-3 agonists, or combination therapy with an alpha blocker and an antimuscarinic medication or beta-3 agonist. (Conditional Recommendation; Evidence Level: Grade B)

• #37 Overactive Bladder | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/o/overactive-bladder.html

  Specialized diagnostics for overactive bladder are called urodynamic tests. They assess bladder function, measure the amount of urine after voiding, the degree of incontinence (how completely the bladder empties), and bladder irritability. […] Measurements are performed by inserting a thin tube through the urethra into the bladder or by performing an ultrasound to acquire an image of the bladder. […] Other specialized tests include: Uroflowmetry is a diagnostic test that uses a device that measures the volume and speed of urination. […] Cystometry uses a device called a cystometer to measure the pressure of the bladder and its capacity. […] It also evaluates the function of the detrusor muscle to determine the degree of muscle contraction, the pressure of any leakage, and the pressure required to fully empty the bladder.

• #38 Overactive bladder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/overactive-bladder/diagnosis-treatment/drc-20355721

  To measure residual urine after you void, your health professional may want an ultrasound scan of your bladder. The ultrasound scan translates sound waves into an image. The image shows how much urine is left in your bladder after you urinate. […] Sometimes, a thin tube, called a catheter, is passed through the urethra and into your bladder to drain the remaining urine. Then the urine can be measured. […] Measuring urine flow rate. To measure how much and how fast you urinate, you may be asked to urinate into a device called a uroflowmeter. A uroflowmeter catches and measures the urine. It then uses the data to create a graph of changes in your flow rate. […] Testing bladder pressures. A test called cystometry measures pressure in your bladder and in the area around it as your bladder fills. After emptying your bladder with a thin tube called a catheter, your health professional uses another catheter to fill your bladder slowly with warm fluid. […] Your health provider reviews the results of your tests with you and suggests a treatment plan.

• #39 Diagnosis of Overactive Bladder – ROC Clinic

  https://rocclinic.com/en/overactive-bladder/diagnosis/

  Urodynamics: to be performed in case of incontinence, when there is no response to initial treatment, when there has been previous surgery in the lower urinary tract or when there is a neurogenic disease. […] Cystoscopy and imaging: to be performed in case of pathological sediment and suspicion of organic bladder involvement. […] Patients with overactive bladder show in the urodynamic study detrusor bladder muscle contractions during filling, which allows the diagnosis of overactive detrusor.

• #40 Overactive Bladder: Etiology, Diagnosis and Treatment

  https://www.urology-textbook.com/overactive-bladder.html

  Overactive bladder (OAB) is urinary urgency, with or without urinary incontinence, usually with increased daytime frequency and nocturia, if there is no proven infection or other obvious pathology (Abrams et al., 2002). […] A micturition diary with documentation of drinking habits, incontinence episodes, pad changes, and voided volumes may help to quantify the severity and bother of OAB. […] Ultrasound imaging of the kidneys and urinary bladder (filled to assess the detrusor thickness and after micturition to determine the residual urine). […] Urodynamic studies are indicated in patients after unsuccessful pharmacological therapy or before invasive treatment. Typical urodynamic findings in patients with an overactive bladder are urinary urgency starting from 100 ml, functional urinary bladder capacity below 250 ml, involuntary detrusor contractions, and possibly urge incontinence.

• #41 Overactive Bladder (OAB): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14248-overactive-bladder

  Overactive bladder is a collection of symptoms that may affect how often you pee and your urgency. […] A healthcare provider can diagnose overactive bladder by reviewing your symptoms and conducting a physical examination of the organs around your pelvis and rectum. […] A healthcare provider may order tests to help diagnose overactive bladder. These tests may include: Urinalysis. A urinalysis (urine test) examines the visual, chemical and microscopic aspects of your pee. […] A healthcare provider will use a special instrument (cystoscope) to look inside your bladder from your urethra. […] Different treatments can help fix your overactive bladder. Treatments may include changing certain behaviors, medications and nerve stimulation (neuromodulation). […] As you’re retraining your bladder, a healthcare provider may prescribe medication. Medications can help restore normal bladder function. Commonly prescribed medications for overactive bladder include: Anticholinergic medications. […] Overactive bladder symptoms can cause considerable stress. Treatment can be challenging to manage, and symptoms may never completely disappear. […] See a healthcare provider if you experience any symptoms of an overactive bladder.

• #42 Diagnosis and Management of Overactive Bladder | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/1001/p1386.html

  Patients with overactive bladder typically have a variety of symptoms that may include urinary urgency and frequency, nocturia, and urge incontinence. […] The author states that a targeted diagnostic evaluation of patients with symptoms of overactive bladder is required. […] All patients should have focused genitourinary, pelvic, and rectal examinations, and a clean-catch urine specimen should be checked for hematuria and infection. […] Cystoscopy should be targeted to patients with unexplained hematuria, recurrent urinary tract infections, or risk factors for bladder cancer. […] Urodynamic testing is relatively more complex and invasive, and the author notes that its role in the diagnostic work-up of overactive bladder is controversial.

• #43 Clinical testing for overactive bladder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3193395/

  The rationale for supplemental testing prior to second-line therapies for OAB has to do with the fact that these therapies may be either invasive, expensive, or have significant side effects. […] Comprehensive urodynamic testing goes beyond the detection and documentation of detrusor overactivity. […] Endoscopic evaluation of the lower urinary tract can identify a number of potential underlying causes of the OAB symptomatology. […] In most cases a good history, physical examination, PVR and voiding diaries (if obtainable) are all that is necessary to initiate treatment of OAB. Further testing is most useful for patients with neurological disease, refractory OAB, or those in whom simple evaluation raises suspicion of an underlying urological or non-urological problem that may require further evaluation or treatment.

• #44 Overactive Bladder Workup: Approach Considerations, Urine Studies, Postvoid Residual Testing

  https://emedicine.medscape.com/article/459340-workup

  Urodynamic study, cystoscopy, and diagnostic renal and bladder ultrasonography are not necessary in the initial workup of uncomplicated cases and should be reserved for refractory or otherwise complicated cases. […] Urine cytology is not recommended in the absence of hematuria when the patient responds to therapy. […] Postvoid residual testing is not indicated in all patients. It is helpful in men with both obstructive and OAB symptoms and in women who have undergone prior pelvic surgery (eg, prior incontinence surgery) and those with significant pelvic organ prolapse. […] A urodynamic study is not indicated as part of the first-line evaluation of patients with OAB unless a neurologic etiology is suspected. […] Examination of the bladder lining and the urethra with cystoscopy may be useful in patients with refractory or otherwise complicated OAB.

• #45 Overactive Bladder | Diagnosis and Treatment

  https://www.genesiscareus.com/en/condition/benign/overactive-bladder

  This imaging test uses sound waves to create detailed images of the inside of your body. Your urologist uses these images to determine if you have OAB. […] This imaging test uses specialized X-ray to create detailed images of the inside of your body. Your urologist uses these images to determine if you have OAB. […] During this test, your doctor uses a thin, flexible tube with a camera on the end (cystoscope) to look inside your bladder. Your doctor uses a specialized viewing monitor to see inside your bladder and determine if you have OAB or another health condition thats causing your symptoms. […] Diagnosis and treatment of overactive bladder should be covered by insurance plans. Contact your specific carrier to be sure you know whats covered.

• #46 Overactive Bladder Syndrome: Evaluation and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5903463/

  Several laboratory tests are recommended in the evaluation of OAB: urine analysis, urinary culture, and blood tests to determine the levels of glycozilated hemoglobin (HbA1C), electrolytes, and levels of creatinine for kidney function evaluation. […] The European Association of Urology and the Japanese Urological Society recommend non-pharmacological and pharmacological treatments for OAB. […] The aim of non-pharmacological treatment is to educate patients about OAB and help them to develop strategies to manage urge and urge incontinence. […] The state of the art pharmacological treatment for OAB is the use of anticholinergic (also called antimuscarinics) drugs. […] Several reviews of randomized trials concluded that antimuscarinic drugs produced a significant improvement or cure. […] Failure in achieving clinical improvement with anti-muscarinic drugs is problematic for the patient and challenging for the physician.

• #47 Overactive Bladder > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/overactive-bladder

  Patients with overactive bladder can be diagnosed after doctors learn about their medical history, perform a physical exam, and offer diagnostic tests. […] No single diagnostic test can confirm overactive bladder. Rather, doctors try to rule out other causes of urinary urgency before diagnosing the condition. […] You may need to give a urine sample to ensure that the cause is not a urinary tract infection. […] Doctors may also order blood work to rule out infections. If a neurological condition is suspected, your doctor may order electromyography (EMG), a diagnostic test that checks the health of muscles and the nerves that control them.

• #48 Overactive bladder syndrome: Management and treatment options

  https://www1.racgp.org.au/ajgp/2020/september/overactive-bladder-syndrome

  Overactive bladder (OAB) is a diagnosis of exclusion that begins with a targeted history and examination of the urogenital system with the aim of assessing the burden of disease on the patient. […] OAB is a diagnosis of exclusion beginning with a targeted history and examination of the urogenital system with an aim to assess the burden of disease facing the patient and affecting their quality of life (refer to Table 2). […] It is important to complete comprehensive history-taking, assessing pertinent past medical history, quantification of local symptoms, urge incontinence and obstetric history. Specific details of incontinence should be interrogated to exclude other types of incontinence. Use of validated questionnaires such as the OAB questionnaire (OAB-q) to assess patient quality of life with urge incontinence, or the International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQOAB) to assess severity and burden assist in providing a baseline from which treatment efficacy can be determined.

• #49 Overactive bladder syndrome Management and treatment options

  https://www.racgp.org.au/afp/2012/november/overactive-bladder-syndrome

  Overactive bladder syndrome is a diagnosis of exclusion. A focused history, including past history of urogenital disorders, in combination with physical examination of the genitourinary system and relevant pelvic examinations should be performed as there are multiple conditions that can cause or contribute to symptoms of overactive bladder. […] Initial and secondary investigations are listed in Table 2. […] Postvoid residual volume (PVR) is best measured with ultrasound (bladder scan or formal ultrasound), with the upper limit of normal being 30 mL. An initially raised PVR requires confirmation before being considered significant as it can be subject to error. […] Increased PVR may contribute to urinary frequency and nocturia, and commencing anticholinergic medications in a patient with increased PVR may worsen bladder function and potentiate urinary retention.

• #50 Overactive bladder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/overactive-bladder/symptoms-causes/syc-20355715

  Overactive bladder happens when the muscles of the bladder start to tighten on their own even when the amount of urine in the bladder is low. These are called involuntary contractions. They cause an urgent need to urinate. […] Although common among older adults, overactive bladder isn’t a typical part of aging. It might not be easy to talk about your symptoms. But if the symptoms distress you or disrupt your life, talk to your healthcare professional. There are treatments that might help. […] Several conditions may be a part of overactive bladder, including: Conditions that affect the bladder, such as tumors or bladder stones. Conditions that affect the brain and spinal cord, such as stroke and multiple sclerosis. Diabetes. Factors that get in the way of urine leaving the bladder, such as an enlarged prostate, constipation or having had surgery to treat lack of control over urinating, called incontinence. Hormonal changes during menopause. Urinary tract infections, which can cause symptoms like those of an overactive bladder.

• #51 Overactive bladder – Wikipedia

  https://en.wikipedia.org/wiki/Overactive_bladder

  Diagnosis of OAB is made primarily on the person’s signs and symptoms and by ruling out other possible causes such as an infection. […] Urodynamics, a bladder scope, and ultrasound are generally not needed. […] Additionally, urine culture may be done to rule out infection. The frequency/volume chart may be maintained and cystourethroscopy may be done to exclude tumor and kidney stones. […] Psychometrically robust self-completion questionnaires are generally recognized as a valid way of measuring a person’s signs and symptoms, but there does not exist a single ideal questionnaire. […] These surveys can be divided into two groups: general surveys of lower urinary tract symptoms and surveys specific to overactive bladder. […] OAB causes similar symptoms to some other conditions such as urinary tract infection (UTI), bladder cancer, and benign prostatic hyperplasia (BPH).

• #52 Overactive bladder – Wikipedia

  https://en.wikipedia.org/wiki/Overactive_bladder

  There is some controversy about the classification and diagnosis of OAB. […] Some sources classify overactive bladder into two different variants: „wet” (i.e., an urgent need to urinate with involuntary leakage) or „dry” (i.e., an urgent need to urinate but no involuntary leakage). […] The distinction is not absolute; one study suggested that many classified as „dry” were actually „wet” and that people with no history of any leakage may have had other syndromes.

• #53 Overactive Bladder Syndrome: Evaluation and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5903463/

  We believe that referral to a urogynecologist or urologist should not be delayed when a conservative non-pharmacological treatment has not been beneficial or for patients who have received a full dose of 1 or 2 antimuscarinic drugs without a sufficient clinical improvement or in those who stopped medical therapy due to adverse effects. […] A new adrenergic drug (Mirabegron) has recently been introduced and has shown some benefit. […] The importance of diagnoses and proper treatment cannot be overemphasized, especially in elderly patients.

• #54 Overactive bladder syndrome: Management and treatment options

  https://www1.racgp.org.au/ajgp/2020/september/overactive-bladder-syndrome

  Initial investigations include routine blood examination and urinalysis to exclude infective causes of incontinence and to detect haematuria and glycosuria. […] On the basis of initial investigations, urological referral may be considered to complete additional investigations including cystoscopy or urodynamics. […] Once a diagnosis of OAB has been made, most patients can progress through a stepwise treatment path from conservative options to medical and finally surgical treatments. […] If conservative treatment and pharmacotherapy do not improve symptoms, minimally invasive treatments such as botulinum toxin A injections, sacral nerve neuromodulation and peripheral tibial nerve stimulation can be trialled. […] Referral to a urologist should be considered for patients where: a significant alternative diagnosis has been identified, such as neurological disease or urothelial carcinoma. […] Following diagnosis, there is a spectrum of treatment options available to patients and medical practitioners to consider in a stepwise approach.

• #55 Overactive bladder – Wikipedia

  https://en.wikipedia.org/wiki/Overactive_bladder

  Diagnosis of OAB is made primarily on the person’s signs and symptoms and by ruling out other possible causes such as an infection. […] Urodynamics, a bladder scope, and ultrasound are generally not needed. […] Additionally, urine culture may be done to rule out infection. The frequency/volume chart may be maintained and cystourethroscopy may be done to exclude tumor and kidney stones. […] Psychometrically robust self-completion questionnaires are generally recognized as a valid way of measuring a person’s signs and symptoms, but there does not exist a single ideal questionnaire. […] These surveys can be divided into two groups: general surveys of lower urinary tract symptoms and surveys specific to overactive bladder. […] OAB causes similar symptoms to some other conditions such as urinary tract infection (UTI), bladder cancer, and benign prostatic hyperplasia (BPH).

• #56 Exploring Overactive Bladder: Diagnosis, Impact, and Treatment Approaches

  https://www.urologytimes.com/view/exploring-overactive-bladder-diagnosis-impact-and-treatment-approaches

  Overactive bladder is a generalized term referring to patients who may experience urinary urgency, frequency, urgency incontinence, nocturia, or a combination of irritative lower urinary tract symptoms. […] I think after a certain age, if I recall, about the age of 62, the same number of men and women can be affected by OAB. […] Traditionally, older patients exhibit more overactive bladder symptoms, while younger patients, being more physically active, often have stress-predominant symptoms that may transition to OAB. […] There are estrogen receptors in the bladder. Replacing vaginal estrogen or even systemic estrogen can oftentimes help these symptoms. […] I think when you’re seeing these OAB symptoms and especially incontinence in young women who have not had children, you should be thinking about other things like there are large conditions that can cause their symptoms.

• #57 Overactive Bladder Differential Diagnoses

  https://emedicine.medscape.com/article/459340-differential

  The term overactive bladder (OAB) refers to a symptom complex. Therefore, the first part of the evaluation of OAB is to review the patients lower urinary tract symptoms to ensure that the symptoms are consistent with OAB. […] A diagnosis of OAB depends on the presence of urgency, which differs from a simple urge to void. A typical urge to void is a normal sensation that progressively strengthens when deferred. In contrast, urgency is an abnormal condition that is characterized by a sudden onset of the desire to void that is difficult to defer. […] The American Urological Association (AUA) and the Society of Urodynamics, Female Pelvic Medicine Urogenital Reconstruction (SUFU) have released joint guidelines on the diagnosis and treatment of non-neurogenic OAB in adults. […] The minimum requirements for the diagnostic process, to document symptoms and signs that characterize OAB and exclude other disorders, are a careful history, physical exam, and urinalysis.

• #58 Overactive Bladder Workup: Approach Considerations, Urine Studies, Postvoid Residual Testing

  https://emedicine.medscape.com/article/459340-workup

  Urodynamic study, cystoscopy, and diagnostic renal and bladder ultrasonography are not necessary in the initial workup of uncomplicated cases and should be reserved for refractory or otherwise complicated cases. […] Urine cytology is not recommended in the absence of hematuria when the patient responds to therapy. […] Postvoid residual testing is not indicated in all patients. It is helpful in men with both obstructive and OAB symptoms and in women who have undergone prior pelvic surgery (eg, prior incontinence surgery) and those with significant pelvic organ prolapse. […] A urodynamic study is not indicated as part of the first-line evaluation of patients with OAB unless a neurologic etiology is suspected. […] Examination of the bladder lining and the urethra with cystoscopy may be useful in patients with refractory or otherwise complicated OAB.

• #59 Clinical testing for overactive bladder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3193395/

  The rationale for supplemental testing prior to second-line therapies for OAB has to do with the fact that these therapies may be either invasive, expensive, or have significant side effects. […] Comprehensive urodynamic testing goes beyond the detection and documentation of detrusor overactivity. […] Endoscopic evaluation of the lower urinary tract can identify a number of potential underlying causes of the OAB symptomatology. […] In most cases a good history, physical examination, PVR and voiding diaries (if obtainable) are all that is necessary to initiate treatment of OAB. Further testing is most useful for patients with neurological disease, refractory OAB, or those in whom simple evaluation raises suspicion of an underlying urological or non-urological problem that may require further evaluation or treatment.

• #60 Overactive Bladder Syndrome: Evaluation and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5903463/

  We believe that referral to a urogynecologist or urologist should not be delayed when a conservative non-pharmacological treatment has not been beneficial or for patients who have received a full dose of 1 or 2 antimuscarinic drugs without a sufficient clinical improvement or in those who stopped medical therapy due to adverse effects. […] A new adrenergic drug (Mirabegron) has recently been introduced and has shown some benefit. […] The importance of diagnoses and proper treatment cannot be overemphasized, especially in elderly patients.

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