Feature Article

Achieving effective management of the overactive bladder

Mariolyn D Raj, Audrey Wang



Appropriate diagnosis and management of overactive bladder (OAB) by GPs is essential in reducing its negative impact on an individual’s quality of life. Successful community-based treatment of OAB involves behavioural therapy, often in conjunction with anticholinergic medications.

Key Points

  • Overactive bladder (OAB) is characterised by urinary urgency with or without urinary incontinence, generally in the presence of frequency and nocturia.
  • OAB is a common condition and the prevalence increases with age.
  • Without treatment, OAB may produce a significant negative impact on an individual’s quality of life.
  • Diagnosis involves history and physical examination, urinalysis, measurement of post-void residual urine volume and assessment of a bladder diary.
  • OAB can be successfully treated in the general practice setting via behavioural modifications (e.g. fluid scheduling, bladder retraining, micturition deferment) and use of anticholinergic medications.
  • Referral of patients to a urologist or urogynaecologist is indicated for those who are refractory to treatment or in whom the diagnosis of OAB is unclear.