Diagnostic Tests

Urodynamic studies are the gold standard for diagnosis. Also urinalysis and urine culture should be negative (rule out urinary tract infection (UTI) as cause of frequency).

In most patients, the cause of bladder overactivity is unknown (idiopathic). Clearly established risk factors for UUI include:

• Increasing age

• Neurologic disorders (e.g., stroke, Parkinson's disease, multiple sclerosis, and spinal cord injury)

• Bladder outlet obstruction (e.g., benign or malignant prostatic enlargement or hy-perplasia)

• Hysterectomy

• Recurrent UTIs

Overactivity may be myogenic or neurogenic in origin or a combination of both. These etiologies appear to be interconnected and complementary.

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