Detrusor Overactivity
Detrusor overactivity is involuntary contraction of the bladder muscle during filling, demonstrated on urodynamic testing and sometimes causing urgency or leakage.
Key takeaways
- Overactive bladder is a symptom syndrome; detrusor overactivity is a test finding, and either can occur without the other.
- Infection, high fluid or caffeine intake, constipation, obstruction and neurological disease can worsen urgency.
- Antimuscarinic and beta-3 agonist medicines have different cognitive, bowel, blood-pressure and urinary-retention risks.
The listings below do not establish detrusor overactivity or safe emptying; urinary history, residual volume and comorbidities guide treatment.
What assessment clarifies
A bladder diary records timing, volumes, urgency and leakage. Urine testing excludes infection, while examination and post-void residual assess pelvic, prostate or emptying problems. Urodynamics is reserved for selected complex cases or when results would change invasive treatment.
Treatment sequence
Bladder training, timed voiding, pelvic-floor strategies and adjustment of fluids or constipation are first steps. Medicines can reduce urgency but may cause dry mouth, constipation, cognitive effects or raised blood pressure. Botulinum toxin or neuromodulation may be considered for refractory symptoms with specialist follow-up.
When to seek urgent care
Seek urgent care for complete inability to urinate, fever with flank pain, visible blood or clots in urine, new leg weakness or numbness, or sudden loss of bladder control with back pain.