最后更新: 8 月 15, 2026

A steady stream of patients arrive at my office having had urinary frequency for years. They have been round several clinics and hospitals, spent a good deal of money, and still have no diagnosis. If that sounds familiar, there is a name for it — 膀胱过度活动症 — and it is a great deal more common than most people realise.

The reason it goes undiagnosed for so long is built into its definition: OAB is what remains once infection and structural problems have been excluded. There is nothing to see on a scan and nothing to grow on a culture, so if nobody thinks of it by name, the search simply continues.

An older woman affected by urinary urgency and frequency from overactive bladder
OAB becomes more common with age and is most often seen in older women.

What overactive bladder actually is

The International Continence Society defines OAB as urinary urgency, with or without incontinence, usually with increased frequency by day and night, and no proven infection or other obvious cause. Urgency is the key word — not simply going often, but the sudden compelling need that is hard to defer.

Patients describe it less clinically. What they tell me about is the fear of leaking, and the way it reorganises daily life around where the toilets are. Around 12% of the general population report OAB symptoms, rising to 20% of women aged 70 and over.

A public toilet sign, representing how overactive bladder reorganises daily life
Knowing where every toilet is becomes a habit — and that is what treatment aims to give back.

How the diagnosis is made

A full history and physical examination, a frequency-volume chart kept over three days, and urinalysis to exclude infection or stones. The chart does more work than patients expect: it turns “I go all the time” into a record of how often, how much, and when — which is what distinguishes a genuinely overactive bladder from simply drinking a great deal of tea or coffee.

Where the picture is unclear, or where symptoms have not responded to treatment as expected, a urodynamic study measures how the bladder actually behaves as it fills and empties. Dr. Soarawee performs urodynamic studies at Bangkok Hospital Headquarters, so this can be arranged without a separate referral.

Treatment, step by step

  1. Lifestyle and bladder training — adjusting how much and when you drink, cutting caffeine and other bladder irritants, stopping smoking, pelvic floor exercises, and gradually stretching the interval between visits to the toilet. This is unglamorous and it is also where most of the improvement comes from.
  2. 口服药物 — anticholinergic agents or beta-3 agonists, the mainstay of medical treatment. If the first drug only partly helps, the dose can be adjusted or a different agent tried; a disappointing response to one tablet is not the end of the road.
  3. Procedures — for the minority who do not respond adequately, bladder botulinum toxin injection and sacral neuromodulation are the established options. Neither is performed at Bangkok Hospital Headquarters; if your case reaches that point, a referral to a centre that provides them can be arranged.

Two expectations worth setting at the start. OAB is usually managed rather than cured, so the goal is a bladder that no longer runs your day rather than one that behaves perfectly. And the improvement comes from doing the dull things consistently — patients who keep up the bladder training alongside the medication do markedly better than those who rely on the tablet alone.

What I most want patients to take away is that this is not something you have to live with silently. It is not life-threatening, which is precisely why it goes unmentioned for years — but it is a quality-of-life problem with real treatment behind it.

如果您出现不明原因的尿频,或怀疑患有过动性膀胱,Soarawee Weerasopone 医生将在曼谷医院总部提供专家咨询。. 预约咨询. 如需预约三美泰是拉差医院,请致电泌尿科: 088-022-1445.

关于膀胱过度活动症(OAB)的常见问题

什么是膀胱过度活动症 (OAB)?

膀胱过度活动症是一种以尿急为特征的疾病——即突然、强烈的排尿冲动且难以延缓——无论是否伴有尿失禁,通常还伴有昼夜排尿次数增加。 该病症在无感染或结构异常的情况下发生,影响约12%的普通人群,在70岁以上女性中这一比例升至20%。.

什么引起膀胱过度活动症?

OAB 是由膀胱未满时膀胱肌肉(逼尿肌过度活跃)异常的自主收缩引起的。促成因素包括衰老、更年期、神经系统疾病(如中风或帕金森病)、盆底肌无力、肥胖、过量饮用咖啡因或摄入液体、以及膀胱刺激物。在许多情况下,找不到单一的明确病因。.

膀胱过度活动症的治疗方法包括行为疗法、药物治疗和手术治疗。行为疗法是最先推荐的治疗方法,通常包括膀胱训练、盆底肌肉训练(凯格尔运动)和液体管理。如果行为疗法效果不佳,会考虑使用药物治疗,常用的药物是抗胆碱能药物和β3受体激动剂。如果药物治疗无效或不能耐受,也可考虑手术治疗,如肉毒毒素注射、骶神经刺激或膀胱增大术。

Treatment follows a stepwise approach. First-line management includes lifestyle modifications such as fluid regulation, bladder training, and pelvic floor exercises. If symptoms persist, oral medications – primarily anticholinergic agents or beta-3 agonists – are prescribed. For patients who do not respond adequately, advanced options include bladder botulinum toxin injection or sacral nerve modulation; these are not performed at Bangkok Hospital Headquarters and a referral can be arranged.

膀胱过度活动症能不能治好?

OAB 在大多数情况下无法完全治愈,但可以很好地控制。通过持续的生活方式改变和规律服药,许多患者的症状可以得到显著改善。对于药物治疗效果不佳的患者,可以调整剂量或尝试其他药物。对于顽固性病例,可以进行侵入性手术治疗。该疾病不危及生命,通过适当的治疗可以显著恢复生活质量。.

每天排尿多少次是正常的?

大多数成年人每天排尿 6-8 次,夜间排尿 0-1 次。24 小时内排尿超过 8 次或夜间排尿超过一次(夜尿)可能表明患有膀胱过度活动症或其他泌尿系统疾病。然而,排尿频率也受液体摄入量、咖啡因摄入量和药物的影响。连续 3 天填写排尿日记有助于泌尿科医生评估排尿模式并指导治疗。.

免责声明 本文由曼谷医院总院的董事会认证泌尿科医师索拉维·维拉索蓬(Soarawee Weerasopone)博士撰写并审核。本内容仅供教育目的,不构成医疗建议。通过私人消息渠道不提供任何医疗建议、诊断或处方。在开始任何医疗治疗之前,请务必咨询合格的医疗保健专业人员。.

医学撰写与审阅: Dr. Soarawee Weerasopone (Dr. Pom) — Board-Certified Urologist, Bangkok Hospital Headquarters, in urological practice since 2016. Fellowship: Robotic Surgery, Chang Gung Memorial Hospital, Taiwan (2019) · Observership: Endourology, Juntendo University Hospital, Tokyo (2022) · Research Scholar & Clinical Observer, Scott Department of Urology, Baylor College of Medicine, USA (2025–2026).

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