Editing AUA: Overactive Bladder (2019) (section)

== Differential Diagnosis ==

# '''<span style="color:#ff0000">Polydipsia and polyuria</span>'''
#'''<span style="color:#ff0000">Nocturia</span>'''
# '''<span style="color:#ff0000">Interstitial cystitis/bladder pain syndrome</span>'''
#'''<span style="color:#ff0000">Atrophic vaginitis</span>'''

=== Polydipsia and polyuria ===
* Frequency that is the result of polydipsia and resulting polyuria may mimic OAB
*'''Diagnosis and Evaluation'''
**'''Can only be distinguished from OAB with the use of frequency-volume charts.'''
***'''In OAB, urinary frequency is associated with many small volume voids.'''
***'''In polydipsia, urinary frequency is associated with normal or large volume voids and the intake is volume matched.''' In this case, the frequency is appropriate because of the intake volume and the patient does not have OAB
***'''Diabetes insipidus''' also is associated with frequent, large volume voids and should be distinguished from OAB.
*Management
**If polydipsia-related frequency is physiologically self-induced: education and consideration of fluid management
**If diabetes insipidus: desmopressin

=== Nocturia ===

* '''Often due to factors unrelated to OAB, including excessive nighttime urine production (i.e. nocturnal polyuria) and sleep apnea.'''
* '''Differential of nocturia includes nocturnal polyuria, low nocturnal bladder capacity or both.''' 
**'''Nocturnal polyuria'''
***Definition: the production of greater than 20 to 33% of total 24 hour urine output during the period of sleep, which is age-dependent with 20% for younger individuals and 33% for elderly individuals.
***Often associated with sleep disturbances, vascular and/or cardiac disease and other medical conditions
***'''Nocturnal voids are frequently normal or large volume as opposed to the small volume voids commonly observed in nocturia associated with OAB.'''

=== Interstitial cystitis/bladder pain syndrome ===

* Clinical presentation of interstitial cystitis/bladder pain syndrome shares the OAB symptoms of urinary frequency and urgency, with or without urgency incontinence
*'''<span style="color:#ff0000">Bladder and/or pelvic pain, including dyspareunia, is a crucial component of its presentation in contradistinction to OAB.</span>'''

=== Atrophic vaginitis ===

* '''In the menopausal female patient, atrophic vaginitis can be a contributing factor to incontinence symptoms.'''
* '''Use of vaginal (but not systemic) estrogen may improve symptoms.'''