Overactive bladder syndrome is a chronic condition that results from hyperactivity of the detrusor muscle, a layer of the urinary bladder wall. This condition is primarily characterised by urinary urgency, and patients may also exhibit symptoms of urge incontinence, frequency and nocturia.

This is different to urge incontinence as patients with OBS typically do not leak urine

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The primary symptom of overactive bladder syndrome is urinary urgency. Additionally, patients may also experience:

• Urge incontinence: involuntary leakage accompanied by or immediately preceded by urgency
• Frequency: urinating more often than what is considered normal
• Nocturia: excessive urination at night

Differential Diagnosis

When diagnosing overactive bladder syndrome, other conditions with similar symptoms should be considered, including:

• Urinary tract infections: Characterised by dysuria, urgency, frequency, suprapubic pain and haematuria.
• Bladder stones: Symptoms include lower abdominal pain, dysuria, intermittent stream, and blood in the urine.
• Interstitial cystitis: Presents with symptoms such as chronic pelvic pain, a persistent, urgent need to urinate, and frequent urination.
• Diabetic neuropathy: Can cause bladder dysfunction, resulting in symptoms like frequent urination and incontinence.

Investigations

The following investigations are key in diagnosing overactive bladder syndrome:

• Urinalysis and culture: To rule out infection
• Frequency/volume chart: To assess the severity of the condition
• Urodynamics: To evaluate bladder muscle function