M.D. Dr. Anderson is Professor of Urology, Stanford University School of Medicine, Stanford, California. In many individuals, the urge incontinence is mixed with anatomic sphincter insufficiency or stress incontinence. Women suffering from anatomic stress urinary incontinence often have neurological detrusor instability or overactivity as a mixed presentation. It may be difficult to clinically determine the predominant factor. This may also occur in men who have had prostate surgery.
Some men develop overactive bladder with a neurological component after ablative prostatic surgery.
Scores on the vitality domain are similar between the overactive bladder, clinical depression, and type II diabetes groups. Overactive bladder affects daily activities such as travel, shopping, physical activity, feelings of self esteem, relationships, sexual function, and nocturnal bladder control. Urinary frequency, particularly nocturnal urinary frequency, annoys the older generation. Prostatic obstruction and inflammation may result in urinary frequency, but nocturnal urinary frequency occurs in older men without such problems. Nocturnal polyuria and a decrease in bladder capacity have been reported to be the most important factors.