How is Overactive Bladder Diagnosed?

Overactive bladder (OAB) affects an estimated 50 million people in the United States, making it a fairly common condition. Unfortunately, treating overactive bladder can be tricky because the symptoms can also be associated with other medical conditions. To access bladder symtpoms, doctors will often ask patients presenting with bladder issues to track their symptoms through a bladder diary, then combine these insights with a patient’s medical history and clinical testing.

Keep reading to learn about bladder diaries and the treatment process for OAB, plus next steps if you are diagnosed with this condition.


Common symptoms of overactive bladder


Overactive bladder may be caused by abnormal communication between the brain and bladder. In a healthy bladder, urine is held until the bladder is full, then the brain signals to the bladder muscles to help release the urine. A patient with overactive bladder, on the other hand, may feel the need to urinate even when the bladder is not full, experience bladder leakages due to an inability to hold urine until it can be released, and other problems with bladder functioning.


The most common symptoms of overactive bladder include:


    • Frequent urination: Frequent urination is defined as urinating so often that it disrupts your daily life – typically 8 or more times in a single day.
    • Nocturia: Patients experiencing nocturia wake up more than 1 time per night to urinate.
    • Bladder urgency, sometimes with incontinence: Patients experiencing bladder urgency feel the need to urinate so strongly that holding or controlling it is difficult. This often leads to incontinence or bladder leakages. There are different types of incontinence, and many people experience a mix of types – learn more in our blog on the subject.


Diagnosing overactive bladder


As mentioned, problems with bladder functioning can have many potential causes. For this reason, doctors must rule out the possibility of other conditions – such as neurological diseases, infections, or adverse effects from medical events such as childbirth or surgery – when examining a patient presenting with bladder issues.

In order to narrow down the cause, doctors will ask patients about their medical history and symptoms and perform a physical exam, typically including at least one clinical test, such as a urinalysis. Keep reading to learn more about each of these diagnostic measures.


Medical history


During a patient’s initial exam, the doctor will ask for details about the patient’s medical history. These questions will typically focus on:


  • How frequently you urinate
  • Whether you experience leakages and how often
  • Whether you experience pain or discomfort while urinating
  • How long you have been experiencing OAB symptoms
  • What medications you take
  • Whether you’ve had recent illnesses or surgeries


As discussed below, keeping a bladder diary can help you keep track of the answers to these questions.


Bladder diary


One common way to gather information about a patient’s experience is to have them track their symptoms using a bladder diary, sometimes called an OAB diary. If you have not already been tracking the details of your symptoms before being examined by your doctor, the doctor will ask you to begin recording:


  • What fluids you drink, how much, and when
  • When you urinate, how long it takes, and the length of time between trips to the bathroom
  • The severity of urgency you experience
  • Whether you experience bladder leakages


The doctor can then use the information in the bladder diary to pinpoint the nature and severity of your symptoms, as well as any lifestyle adjustments that may be necessary when it comes to treating your condition.


Physical exam


During the physical exam, the doctor will look at the patient’s abdomen, pelvis, genitals, and rectum to detect any abnormalities. Because OAB causes and symptoms can be influenced by gender, the exam will differ slightly between female patients and male patients. For women, doctors will perform a thorough pelvic exam, while for men, they will perform a prostate exam.


Clinical testing


Problems with bladder function can be caused by neurological conditions, such as Parkinson’s Disease or Multiple Sclerosis. For this reason, doctors may perform a neurological exam to check the patient’s motor reflexes.

Doctors may also perform a cough or stress test to see if a patient experiences stress incontinence, or bladder leakages caused by coughing, sneezing, or other movements that can put pressure on the bladder.

Finally, the doctor may perform a urinalysis, or a test of the patient’s urine sample, to rule out conditions such as urinary tract infections (UTI) and diabetes, which can cause symptoms  of OAB. The doctor may also perform urodynamic tests, which measure the bladder’s ability to empty properly, or a uroflowmetry test to measure the speed and volume of urination and determine whether there is an obstruction (such as bladder stones).


Treating overactive bladder


Overactive bladder is a chronic condition, meaning there is no cure – only treatment for symptoms. However, if your doctor gives you a diagnosis of OAB, all is not lost. There is a range of effective treatment options at your disposal to help you manage your condition.

First-line treatments involve behavioral and lifestyle changes. This can include modifications to diet and fluid intake, bladder training, pelvic floor exercises, and more. If behavioral interventions do not resolve symptoms, doctors may prescribe medications. Finally, if behavioral and pharmaceutical interventions fail, there are advanced therapies available, including implants and surgeries.


The Axonics System


OAB can be a source of frustration and embarrassment, but it is possible to take back your life. Axonics has developed a minimally invasive implant designed to help restore normal bladder functioning through stimulation to the sacral nerve. If you haven’t had success with behavioral treatments or medication, find out whether Sacral Neuromodulation is right for you.


Disclaimer: Axonics does not provide medical advice, diagnosis or treatment. The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.