Editing Functional: Overactive Bladder (section)

== Diagnosis and Evaluation ==

* '''Mandatory by 2017 CUA OAB Guidelines (4):''' 
*#'''H+P'''
*#'''U/A'''
*#'''Questionnaire'''
*#'''Voiding diary'''

=== History and Physical Exam ===
* '''History'''
** '''Characterize LUTS''' (presence or absence, incidence, severity, bother, and effect on quality of life for each of the OAB symptoms (urgency, urgency incontinence, increased daytime frequency, and nocturia).
*** Patients with urgency tend to describe frequent voids with a low typical voided volume.
*** Nocturia is somewhat variable in OAB.
*** Voiding and postmicturition LUTS, dysuria, hematuria, and LUT pain should also be assessed.
** '''Nature and volume of fluid intake''', recognizing that stimulants and polydipsia affect LUTS, and that patients may adapt their intake to reduce the impact of symptoms.
** '''Whether occult neurologic disease could be''' '''present'''; for example, recent onset of OAB with symptoms of erectile dysfunction or tremor.
** '''Obstetric and gynecologic history, previous surgery and/or radiotherapy, bowel symptoms, and medication history.'''
** '''Other medical issues''' '''(e.g., contraindications to antimuscarinic therapy (see Pharmacological Managments of LUTS Chapter Notes)'''
* '''Physical Exam'''
** Abdominal and pelvic examination, general examination (e.g., peripheral edema), and basic neurologic examination.
** Assessment of bladder emptying is necessary (most simply by palpating the lower abdomen if the patient is slim).

=== Labs ===
* '''Urinalysis'''
** Important in all patients to exclude urinary tract infection, hematuria, and leukocyturia.

=== Other ===
* '''Questionnaire'''
** '''The most time-efficient and systematic way to explore contributory LUTS is to use a symptom assessment questionnaire.'''
* '''Frequency volume chart'''
** Remains the principal method for evaluating frequency and nocturia in an objective way.