OAB symptoms: assessment and discriminator for etiopathology

Overactive bladder (OAB) is a highly common condition defined by characteristic symptoms and absence of obvious diseases. OAB symptoms are reviewed with special relevance to its etiopathlogy.

Numerous validated assessment tools are available for OAB symptoms. They are variable in question items and response scale, but most of them are highly responsive to quality of life impairment and treatment outcomes. It should be kept in mind whether the tool addresses symptoms including OAB symptoms, OAB symptoms alone, or symptom bother. The cardinal symptom of OAB is urgency, a strong desire to void of sudden onset. Suddenness of urgency is associated with symptom severity and its all-or-none nature is indicative of a disorder in bladder afferent signal processing.

Etiopathology of OAB or urgency is highly heterogeneous and may be found in detrusor muscle, bladder nervous system, and the brain. OAB is reflective of a condition of sensory dysfunction of the bladder, wherein the patients feel a strong desire to void at a smaller bladder volume (sensory hyperactivity) and notice desire to void too late (impaired perception). This ambivalent condition could be named as 'sensory hyperactivity with impaired perception'.