Editing AUA: Overactive Bladder (2019) (section)

=== Optional ===
==== Urine culture ====
* Usually not necessary unless indication of infection (i.e., nitrites/leukocyte esterase on dipstick, pyuria/bacteriuria on microscopic exam) is found
*'''In some patients with irritative voiding symptoms but without overt signs of infection, a urine culture may be appropriate to completely exclude the presence of clinically significant bacteriuria'''
**Urinalysis is unreliable for identification of bacterial counts <100,000CFU/mL. 

==== Post-void Residual ====
* Measured with an ultrasound bladder scanner immediately after the patient voids.  
**If an ultrasound scanner is not available, then urethral catheterization may be used to assess PVR.
*'''<span style="color:#ff0000">Not necessary for patients who are receiving first-line behavioral interventions or for uncomplicated patients (i.e., patients without a history of or risk factors for urinary retention) receiving antimuscarinic medications.</span>'''
* '''<span style="color:#ff0000">Indications to assess PVR (4)</span>'''
*#'''<span style="color:#ff0000">Neurologic diagnoses</span>'''
*#'''<span style="color:#ff0000">History of incontinence surgery or prostatic surgery</span>'''
*#'''<span style="color:#ff0000">Presence of voiding/obstructive symptoms</span>'''
*#*As there is considerable overlap between storage and emptying voiding symptoms, baseline PVRs should be performed for males with symptoms prior to initiation of anti-muscarinic therapy.
*#'''<span style="color:#ff0000">Clinician discretion</span>'''
*'''<span style="color:#ff0000">Anti-muscarinics should be used with caution in patients with PVR 250–300 mL.</span>'''
*For any patient on anti-muscarinic therapy, the clinician should be prepared to monitor PVR during the course of treatment should obstructive voiding symptoms appear.

==== Bladder Diary ====
* '''See [https://www.urologyhealth.org/documents/Product-Store/English/Overactive-Bladder-OAB-Bladder-Diary.pdf Urology Care Foundation Link]'''
*'''<span style="color:#ff0000">Documents (2)'''
*#'''<span style="color:#ff0000">Intake AND'''
*#'''<span style="color:#ff0000">Voiding behavior'''
*##'''At a minimum, the patient documents (2):'''
*###'''Time of each void'''   
*###'''Incontinence episode and the circumstances or reasons for the incontinence episode.'''
*##'''Other useful measures'''
*##*'''Voided volumes'''
*##**Provide a practical estimate of the patient's functional bladder capacity in daily life and estimate the amount of overall fluid intake.
*##**Useful to differentiate between polyuria (characterized by normal or large volume voids) from OAB (characterized by frequent small voids).
*##*Rating the degree of urgency associated with each void and incontinence episode
*'''May be useful, particularly for patient education and to document baseline symptoms and treatment efficacy'''              
**'''Self-monitoring with a bladder diary for 3-7 days is a useful first step in initiating behavioral treatments for OAB.''' 
***Usually completed for only 24 to 48 hours due to burden of monitoring

==== Symptoms questionnaire ====
* '''Useful in the quantification of bladder symptoms and bother changes with OAB treatment'''
*Options (4)
*#Urogenital Distress Inventory (UDI)
*#UDI-6 Short Form
*#Incontinence Impact Questionnaire (II-Q)
*#Overactive Bladder Questionnaire (OAB-q)