Overactive Bladder (OAB) is a syndrome characterized by symptoms of urinary urgency, often associated with urinary frequency and nocturia, with or without urge incontinence; it can manifest urodynamically as Detrusor instability, or detrusor overactivity, or other forms of urethro-vesical dysfunction. OAB has no clear etiology and does not include symptoms caused by acute urinary tract infections or other forms of localized lesions of the vesicourethra.
It is usually considered that adults are considered to have frequent urination when they reach a frequency of ≥ 12 times during the day and ≥ 2 times during the night, with an average volume of < 200 ml per urination. Nocturia is defined as a patient’s complaint of ≥2 times/night and awakening to urinate due to the urge to urinate. The difference between OAB and Lower Urinary Tract Symptoms (LUTS) is that OAB only includes symptoms of the urinary storage phase, while LUTS includes both symptoms of the urinary storage phase and symptoms of the urinary voiding phase, such as difficulty in urination. The etiology of OAB is not very clear, but the following four types are considered: 1. instability of the detrusor muscle caused by non-neurogenic factors, abnormal contraction of the detrusor muscle during the storage phase causes the corresponding clinical symptoms. 2. 2, bladder sensory hypersensitivity The desire to urinate occurs at smaller bladder volumes. 3.Abnormal function of urethra and pelvic floor muscles. 4.Other causes: such as abnormal mental behavior, hormone metabolism disorder, etc. 2.Optional treatment 1.Botulinum toxin type A multi-point injection of bladder forced urinary muscle It is effective for severe forced urinary muscle instability. 2.Bladder perfusion RTX, hyaluronidase, capsaicin The above substances can be involved in bladder sensory afferents, and reduce bladder sensory afferents after perfusion, and can be tried in severe bladder sensory allergy. 3.Neuromodulation Sacral nerve electro-modulation therapy is effective for most patients with intractable urinary frequency and urgency and urinary incontinence.