What is overactive bladder (OAB) in children?

Updated: Apr 01, 2019
  • Author: Pamela I Ellsworth, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Idiopathic overactive bladder (OAB) is a term that has been adopted by the International Continence Society (ICS) to describe the symptom complex of urinary urgency, which may or may not be associated with urgency urinary incontinence, urinary frequency, and nocturia in the absence of pathologic or metabolic factors that cause or mimic these symptoms. [1]

In the pediatric literature, OAB is often referred to as urge syndrome and is best characterized by frequent episodes of an urgent need to void, countered by contraction of the pelvic floor muscles and holding maneuvers such as squatting and the Vincent curtsy sign.

The cardinal symptom of OAB is urgency, which is defined as a sudden compelling desire to void that is often difficult to defer. Urgency must be differentiated from the urge to void, which is a normal sensation experienced by all individuals and may be intense when urine is held for a prolonged period.

The definition of urinary frequency in a child is not well established. However, many believe that a child who has a normal fluid intake and who voids more than 7 times per day has urinary frequency. The ICS defines nocturia as the need to wake at night 1 or more times to void.

Depending on fluid intake and urine production, children may experience more episodes of incontinence later in the day as a consequence of fatigue and an impaired ability to concentrate. In some cases, children with OAB remain dry during the day yet wet at night. However, such children experience daytime urgency and, often, daytime frequency.

For more information, see Overactive Bladder.

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