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Introduction
The aim of this study is to evaluate the differential diagnosis in women with symptoms of overactive bladder (OAB).
Methods
This is a retrospective study demonstrating the differential diagnosis of women with symptoms of OAB using a previously validated OAB symptom questionnaire (OABSS). All patients underwent history and physical, OABSS questionnaire, 24-hour voiding diary, urinalysis, uroflow and post-void residual. Cystoscopy and urodynamics were completed when required for diagnosis. Selection criteria were developed to assign patients to the various diagnostic categories.
Results
125 women (mean age 67) met inclusion criteria for OAB. Cystoscopy and urodynamics were completed in 106 (85%) women and detrusor overactivity was demonstrable in 54 (43.2%). The differential diagnosis for all patients and patients with OABSS≥9 is listed in Table 1. 103 (82.4%) patients had an OABSS≥9 with a mean OABSS of 15.4 (range 5-27, SD 5.5). The differential diagnosis of this subset of patients is listed in table along with mean OABSS for each category.
Conclusion
Women who present with OAB symptoms exhibit a differential diagnosis of concomitant urologic pathologies, we believe that OAB should be considered a symptom complex, not a syndrome. This series confirms that up to 79% of women with OAB symptoms have other diagnosable conditions, many of which may be remediable to treatment.