Overactive bladder (OAB) affected about 33 million men and women in the United States. Despite its frequency, OAB was an often misdiagnosed illness. OAB symptoms are similar to those of other prevalent urologic disorders, such as recurrent urinary tract infections (UTIs). For a study, researchers discussed important differentiating aspects of OAB that helped in proper diagnosis, as well as current developments in OAB management. According to recent research, the majority of women who presented with lower urinary tract symptoms were diagnosed with UTIs and treated without obtaining a urine culture as normal treatment. When urine cultures were collected, the authors discovered that fewer than half of the women had a positive pee culture, suggesting that empiric treatment of UTIs without cultures frequently resulted in a UTI misdiagnosis. OAB symptoms have been shown to coincide with those of several prevalent illnesses, most notably UTI, BPH, and bladder cancer/carcinoma in situ. Despite the fact that OAB and UTI have similar symptomatology, the timing of symptom onset was generally extremely different between the two. UTI symptoms were often acute, but OAB symptoms were typically persistent. Urgency, frequency, and nocturia were all symptoms of OAB and UTI. However, dysuria and hematuria were not symptoms of OAB, although they were common in UTI. Urgency, frequency, and nocturia are uncommon in bladder cancer/carcinoma in situ; when these symptoms do arise, they are usually in the context of microhematuria. According to one study, 41% of patients with carcinoma in situ had macroscopic hematuria and 44% had microscopic hematuria at presentation. To rule out the risk of cancer in individuals with lower urinary tract symptoms, a urinalysis (UA) was performed to check for microhematuria. In the absence of UTI, the first-line treatment for OAB is behavioral change, which includes bladder training, hydration control, and pelvic floor exercises. Behavioral modification tactics have been shown in several studies to be the most effective first step in treatment. Although vaginal estrogen was commonly used to treat recurrent UTIs and vaginal atrophy in postmenopausal women, several review articles showed that it is also an effective treatment for lower urinary tract symptoms.
It was critical to identify OAB from other illnesses that appeared with similar symptoms in order to avoid misdiagnosis, treatment delays, and antibiotic misuse. Researchers discussed critical factors that separated OAB from UTI, the most usually misdiagnosed illness among patients presenting with lower urinary tract symptoms, in this article (LUTS). Given that UTI is the most usually misdiagnosed infection among women with OAB, they proposed that urine cultures and the constellation of acute-onset dysuria, frequency, and urgency be used as more essential diagnostic markers in separating these disorders.
Reference:link.springer.com/article/10.1007/s11934-018-0839-3
