Overactive Bladder: Causes, Symptoms, and Diagnosis - Urology

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Understanding Overactive Bladder (OAB) is crucial for managing symptoms and improving quality of life. OAB is characterized by a sudden urge to urinate that may be difficult to control, often accompanied by increased frequency of urination and, in some cases, urgency incontinence. Let's address your questions systematically.

1. Causes of Frequent Urinary Tract Infections (UTIs): You mentioned experiencing two episodes of cystitis (bladder inflammation) with blood in your urine within a short time frame. While maintaining good hygiene practices, such as urinating before and after sexual intercourse, is essential, there are other factors that can predispose individuals to recurrent UTIs. These include anatomical abnormalities, urinary stones, hormonal changes (especially in postmenopausal women), and certain medical conditions like diabetes. It's also possible that you may have a chronic low-grade infection or inflammation that hasn't been fully resolved. A urologist may recommend imaging studies, such as an ultrasound or CT scan, to check for stones or other abnormalities.

2. Antibiotic Duration and Prophylaxis: The standard duration for treating uncomplicated UTIs is typically 5 to 7 days, but in cases of recurrent infections, your doctor may consider a longer course or a different antibiotic. Prophylactic antibiotics after sexual intercourse can be effective for some individuals who experience recurrent UTIs. Discussing this option with your healthcare provider is advisable, as they can tailor the approach based on your specific history and risk factors.

3. Definition of OAB: The definition of OAB includes urinating more than eight times in a 24-hour period, regardless of whether it occurs during the day or night. However, the frequency can vary based on individual circumstances and fluid intake. If you find yourself needing to urinate more than eight times during your waking hours, it may indicate OAB.

4. Understanding Urinary Frequency and Volume: Your description of needing to urinate every 10 minutes, with a volume of 100-150 ml each time, suggests that your bladder may be overactive. In OAB, the bladder can contract involuntarily, leading to frequent urges and a feeling of incomplete emptying. This can result in the sensation of needing to urinate again shortly after having just done so. The bladder's ability to store urine can be affected by various factors, including bladder wall sensitivity and muscle tone.
5. Diagnosis of OAB: Besides the frequency and urgency criteria, a urodynamic study (UDS) can help confirm a diagnosis of OAB. This test evaluates how well the bladder and urethra are storing and releasing urine. Other assessments may include a bladder diary, which tracks your fluid intake, urination frequency, and volumes over a few days.
In summary, your symptoms warrant a thorough evaluation by a urologist, who can help determine the underlying causes of your recurrent UTIs and bladder issues. They may recommend further testing to rule out anatomical abnormalities or other conditions contributing to your symptoms. Treatment options for OAB may include lifestyle modifications, bladder training, medications, or even physical therapy. It's essential to address these concerns comprehensively to improve your quality of life and manage your symptoms effectively.