Overactive Bladder

Physical Examination

General physical and neurological examinations should be performed. It is unusual, however, for a neurological examination to reveal unsuspected neurological dysfunction.

Investigations

An initial evaluation should include an assessment of the patient's symptoms, detailed physical examination and urinalysis.

Once urinary tract infection has been excluded, it is possible to establish a working diagnosis based on the patient's description of symptoms. In cases where there is uncertainty regarding the diagnosis, more advanced investigations should be carried out.

These include:

• Urine cytology - To detect bladder tumour
• Frequency Volume Chart - A chart of the timing and volume of output to indicate the severity of the problem. Follow-up charts are also useful to provide evidence of a response to treatment
• Filling and Voiding Cystometry - Cystometry is the mainstay of investigation and is the only method of objective assessment of overactive bladder
• Ambulatory Urodynamics - Only for patients in whom a routine cystometry in a laboratory setting cannot elicit detrusor contractions
• Cystoscopy - To look for bladder stone, tumour or inflammation