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Overactive bladder - Symptoms and diagnosis
Medical expert of the article
Last reviewed: 04.07.2025
Symptoms of Overactive Bladder
Frequent daytime and nighttime urination, the predominant symptoms of overactive bladder, occur approximately 2 times more often in the absence of urgent urination and 3 times more often without urgent urinary incontinence. Urgent urinary incontinence is the most severe manifestation of hyperreactive bladder, since it causes significant suffering to patients. The peculiarity of the course of hyperreactive bladder is the dynamics of its symptoms. Over 3 years of observation, urgent urinary incontinence spontaneously regresses in almost a third of patients without treatment and relapses again at different times. Frequent urination is the most persistent symptom, often leading patients to absolute disability and often pushing them to rash decisions.
Diagnosis of overactive bladder
All patients with frequent and urgent urination, in addition to collecting anamnesis and physical examination, undergo an assessment of urination frequency using a urination diary, urine sediment examination and bacteriological analysis of urine, ultrasound scanning of the kidneys, bladder, prostate with determination of residual urine. The results of the urination diary are most important for the diagnosis of overactive bladder, allowing a quick decision on the initiation and methods of treatment. The diagnosis of "overactive bladder" is established in the presence of at least eight urinations and / or at least two episodes of urgent urinary incontinence during the day in the absence of other causes capable of causing these symptoms. Thus, overactive bladder is a diagnosis of exclusion. It is important that the results of this primary examination, carried out at the outpatient stage, often allow us to identify diseases accompanied by symptoms of frequent and urgent urination, but not related to overactive bladder.
If a hyperreactive bladder is detected, treatment can be started immediately to improve the patient's quality of life by stopping frequent and urgent urination. If treatment is ineffective or at the patient's request, the forms of hyperreactive bladder are specified (idiopathic or neurogenic detrusor overactivity, hyperreactive bladder without detrusor overactivity). For this purpose, cystometry and special tests with cold water and lidocaine are performed, which allow identifying neurological disorders underlying the development of detrusor overactivity. In all cases, if detrusor overactivity is detected, a detailed neurological examination is indicated.
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