When You Gotta Go, You Gotta Go – Diagnosing Overactive Bladder
Even though overactive bladder affects some 33 million adults in the U.S., it remains one of the most embarrassing topics for all who suffer from this condition. That’s why OAB, also known as urge incontinence, is often called the “hidden condition.”
What is overactive bladder? It is a condition where you have the intense urge to urinate before you can reach the restroom. If you don’t reach the restroom in time, you loose the urine and soil your clothes and the embarrassment is overwhelming. Those who suffer from OAB will know where every restroom is between their home and their next destination. This is referred to as “toilet mapping.” In severe cases those who suffer become depressed and reclusive and will stop engaging in socialization and remain at home.
How Does You Doctor Diagnose Overactive Bladder?
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.
Questions your doctor may ask about your OAB include:
- How often do you urinate?
- How often do you leak urine, and how severely?
- Do you feel any pain or discomfort while urinating?
- For how long has the urge or urinary incontinence been occurring?
- What medications are you taking?
- Have you had any recent surgery or illnesses?
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.
Your doctor will then examine your abdomen, pelvis, genitals, and rectum. You might also have a neurological exam to look for problems in your nervous system that could affect your ability to urinate.
What Are the Tests for Overactive Bladder?
There are a number of OAB tests, 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, or a gynecologist.
Tests for overactive bladder include:
Urinalysis. Taking a urine sample allows your doctor to check for conditions that can cause overactive bladder. A urinalysis looks for the presence of these substances in the urine:
Bacteria, which could indicate a urinary tract infection
- Blood or protein, which could be a sign of a kidney problem
- Glucose, which could signal diabetes
Cystoscopy. If your urinalysis reveals blood in your urine, or you have frequent urinary tract infections, the doctor might send you for this test, which uses a thin, lighted instrument called a cystoscope to look for cysts and other growths in the bladder.
Urodynamic testing. This series of OAB tests measures how well your bladder holds and empties urine. Urodynamic tests include:
Post urination 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. The catheter drains the urine that remains in your bladder and measures it. Another way to test post void residual urine is with an ultrasound, which uses sound waves to look at how much urine is left in your bladder after you go.
Uroflowmetry. As you urinate into a funnel, this test measures the amount and speed of the urine flow to see if there is any obstruction blocking urination.
Cystometry. In this test, a catheter fills the bladder with water or air. This test measures the pressure in the bladder as it fills with fluid or air.
Voiding cystourethrogram. This overactive bladder test looks for structural problems in the bladder and urethra. A liquid dye is inserted into your bladder with a catheter, and then X-rays are taken while you urinate.
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.
Bottom Line: OAB is a common medical condition affecting millions of American women and men. The diagnosis is easily made in the doctor’s office after one or two visits.
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