Diagnosis and treatment of overactive bladder.

Overactive bladder is a very common condition, affecting an estimated 50 to 100 million people worldwide. More than 90% of women with overactive bladder have no recognizable pathology. Several risk factors have been recognized for overactive bladder syndrome and incontinence including age, diabetes, Caucasian race, and hormone replacement therapy. The gold standard for diagnosing detrusor overactivity is multichannel urethrocystometry, although single channel cystometry or even simple cystometry may be used. A variety of interventions are available for the treatment of the overactive bladder syndrome. These include behavioral interventions, pelvic floor electrical stimulation, electromagnetic innervation, neuromodulation, intravesical instillations and injections, operative bladder augmentation, and pharmacotherapy. In any therapy for overactive bladder symptoms, expectations play a pivotal role in success or failure, and communication between the healthcare provider and the patient is essential for setting and achieving treatment goals.