Overactive bladder: symptoms and diagnosis

Symptoms of a hyperactive bladder

Increased daytime and nighttime urination, the predominant symptoms of a hyperactive bladder, are about 2 times more frequent in the absence of urgent urination and 3 times more often without urgent urinary incontinence. Urgent urinary incontinence is the most severe manifestation of the hyperreactive bladder, as it causes considerable suffering for patients. The peculiarity of the course of the hyper-reactive bladder is the dynamics of its symptoms. Within 3 years of observation, in almost a third of patients, urgent urinary incontinence spontaneously regresses without treatment and again recurs at different times. Increased urination is the most persistent symptom, often leading patients to absolute disability and often pushing them to rash decisions.

Diagnosis of a hyperactive bladder

All patients with frequent and urgent urination, in addition to collecting anamnesis and physical examination, assess the frequency of urination with a diary of urination, urine sediment and urine bacteriological analysis, ultrasound scanning of the kidneys, bladder. Prostate with the determination of residual urine. The results of the diary of urination are most important for the diagnosis of the hyper-reactive bladder, allowing you to quickly decide the question of the beginning and methods of treatment. The diagnosis of a "hyperreactive bladder" is established in the presence of at least eight urination and / or at least two episodes of urge incontinence within 24 hours in the absence of other causes that can cause these symptoms. Thus, the hyper-reactive bladder is the diagnosis of an exception. It is important that the results of this initial survey conducted at the polyclinic stage often reveal diseases accompanied by symptoms of rapid and urgent urination, but not related to the hyper-reactive bladder.

If a hyper-reactive bladder is detected, treatment can be started immediately to improve the quality of life of the patient by stopping rapid and urgent urination. In case of ineffective treatment or at the request of the patient, the forms of the hyper-reactive bladder (idiopathic or neurogenic detrusor hyperactivity, hyperreactive bladder without detrusor hyperactivity) are specified. To do this, conduct cystometry and special tests with cold water and lidocaine. Which allow to identify neurological disorders, underlying the development of detrusor hyperactivity. In all cases, in the detection of detrusor hyperactivity, a detailed neurological examination is shown.

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