Overactive Bladder: Making the Diagnosis

Even though overactive bladder affects some 33 million adults in the U.S., OAB can be an embarrassing subject to discuss, even with your doctor. That’s why OAB, also known as urge incontinence, is often called the “hidden condition.”

You might believe, as many people do, that overactive bladder is just an unpleasant but inescapable part of getting older. Actually it isn’t -- and there is something you can do. Seeing your doctor and having tests for overactive bladder can help you get treatment, get back into your old routine, and feel more like yourself again.

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. Your doctor will examine you, ask questions, and perform OAB tests.

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). If you’re a woman, you can also visit a urogynecologist.

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

Bladder stress test and Bonney test. To see whether you’re leaking urine, your doctor might do a bladder stress test, which consists of filling your bladder with fluid and then asking you to cough. The Bonney test is similar, except the doctor inserts a finger or instrument in the vagina to lift the bladder neck while you cough.

 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.