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Overactive bladder (OAB), also known as overactive bladder syndrome, is a condition where there is a frequent feeling of needing to urinate to a degree that it negatively affects a person's life. The frequent need to urinate may occur during the day, at night, or both.〔(【引用サイトリンク】url=https://www.nlm.nih.gov/cgi/mesh/2015/MB_cgi?field=uid&term=D053201 )〕 If there is loss of bladder control then it is known as urge incontinence.〔 More than 40% of people with overactive bladder have incontinence. While about 40% to 70% of urinary incontinence is due to overactive bladder. It is not life-threatening. Most people with the condition have problems for years. The cause of overactive bladder is unknown.〔 Risk factors include obesity, caffeine, and constipation.〔 Poorly controlled diabetes, poor functional mobility, and chronic pelvic pain may worsen the symptoms. People often have the symptoms for a long time before seeking treatment and the condition is sometimes identified by caregivers.〔 Diagnosis is based on a person's signs and symptoms and requires other problems such as urinary tract infections or neurological conditions to be excluded.〔〔 The amount of urine passed during each urination is relatively small. Pain while urinating suggests that there is a problem other than overactive bladder.〔 Specific treatment is not always required.〔 If treatment is desired pelvic floor exercises, bladder training, and other behavioral methods are initially recommended. Weight loss in those who are overweight, decreasing caffeine consumption, and drinking moderate fluids, can also have benefits. Medications, typically of the anti-muscarinic type, are only recommended if other measures are not effective. They are no more effective than behavioral methods; however, they are associated with side effects, particularly in older people.〔 Injections of botulinum toxin into the bladder is another option. Urinary catheters or surgery are generally not recommended. A diary to track problems can help determine whether treatments are working.〔 Overactive bladder is estimated to occur in 7-27% of men and 9-43% of women. It becomes more common with age. Some studies suggest that the condition is more common in women, especially when associated with loss of bladder control.〔 Economic costs of overactive bladder were estimated in the United States at 12.6 billion USD and 4.2 billion Euro in 2000. ==Signs and symptoms == Overactive bladder is characterized by a group of four symptoms: urgency, urinary frequency, nocturia, and urge incontinence. Urge incontinence is not present in the "dry" classification. Urgency is considered the hallmark symptom of OAB, but there are no clear criteria for what constitutes urgency and studies often use other criteria.〔 Urgency is currently defined by the International Continence Society (ICS), as of 2002, as "Sudden, compelling desire to pass urine that is difficult to defer." The previous definition was "Strong desire to void accompanied by fear of leakage or pain."〔Can Urol Assoc J 2011;5(5Suppl2):S135-S136; 〕 The definition does not address the immediacy of the urge to void and has been criticized as subjective.〔 Urinary frequency is considered abnormal if the person urinates more than eight times in a day. This frequency is usually monitored by having the patient keep a voiding diary where they record urination episodes.〔 The number of episodes varies depending on sleep, fluid intake, medications, and up to seven is considered normal if consistent with the other factors. Nocturia is a symptom where the person complains of interrupted sleep because of an urge to void and, like the urinary frequency component, is affected by similar lifestyle and medical factors. Individual waking events are not considered abnormal, one study in Finland established two or more voids per night as affecting quality of life. Urge incontinence is a form of urinary incontinence characterized by the involuntary loss of urine occurring for no apparent reason while feeling urinary urgency as discussed above. Like frequency, the person can track incontinence in a diary to assist with diagnosis and management of symptoms. Urge incontinence can also be measured with pad tests, and these are often used for research purposes. Some people with urge incontinence also have stress incontinence and this can complicate clinical studies.〔 It is important that the clinician and the patient both reach a consensus on the term, 'urgency.' Some common phrases used to describe OAB include, 'When I've got to go, I've got to go,' or 'When I have to go, I have to rush, because I think I will wet myself.' Hence the term, 'fear of leakage,' is an important concept to patients.〔Campbell-Walsh Urology, Tenth Edition, Chapter 66, Page 1948〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「overactive bladder」の詳細全文を読む スポンサード リンク
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