Overactive bladder: a new paradigm

Excerpt

“I have overactive bladder,” said a patient.

“What do you mean?,” said I.

“You don’t know what overactive bladder is?,” she said incredulously. “You’re a doctor!”

“I know what I mean by OAB; I want to know what you mean.”

“I don’t have any control of my bladder.”

“What do you mean?”

“I go too often, and when my bladder gets full, if I wait too long, I can’t get to the bathroom in time and I wet myself.”

“That’s not overactive bladder.”

“What is it then?”

“I don’t know; there are no words to describe your condition.”

“Wow, is it that rare?”

“No, it is actually one of the most common conditions that I see.”

“So why don’t you know what it is?”

“I do know what it is, I just don’t know what to call it. I used to call it OAB, but they told me I couldn’t use that term any more.”

“Why can’t you use it?”

“Sudden,” I said. “You didn’t say that you got a sudden desire to pass urine that is difficult to defer.”

“OK, so let’s say it’s sudden (it’s not). Can we call it OAB now? Can you treat me now.”

“Sure. As long as it’s sudden.”

“But ‘desire?’ I don’t ever get a desire to urinate. Frankly, considering how often I go, I’d be quite happy to never urinate again if I could. Would that be harmful?”