INDIVIDUALS ARE FACED WITH varying aspects of health problems that have an impact on their quality of life. Suffering a nonfatal heart attack certainly changes one's appreciation of life, which may result in a vigilant awareness of blood pressure, a change in diet, an initiation of an exercise program, a reduction in smoking along with other adjustments of daily life. The severity of a health condition may be manifested in subtle ways, yet have a major impact on quality of life. For many of us, we do not realize the simplicity of normal urinary bladder function. However, overactive bladder syndrome (OAB, also referred to as overactive detrusor function) is a condition that has symptoms of urgency for urination (micturition) with or without urge incontinence, high frequency of urination, and nocturia (waking at night to urinate) (1). OAB has a significant cost to the individual and the healthcare system. Indeed, in 2008, an estimated ϳ11% of the world population was affected by OAB and it was estimated to grow to 20% by 2018 (6). In 2008 alone, it was estimated that the collective direct cost burden for Canada, Germany, UK, Italy, Sweden, and Spain was £3.9 billion, which did not include nursing home costs (7). Other costs of OAB escalate the personal and economic impact when one factors in absenteeism from work and decreased productivity while at work (7). It is obvious that the cost burden of OAB to the quality of life of the individual, the healthcare system, and the workforce is substantial.Generally, our understanding of the reason why OAB is manifested is unknown. The detrusor smooth muscle (DSM) of the wall of the urinary bladder is key to the function of the bladder (1). The cells of the DSM relax during the process of filling and storing urine in the bladder for long periods of time without leakage. Additionally, for urination to occur, the DSM cells must synchronously contract in concert with coordinated function of the internal and external sphincters of the urethra. This integrative function is controlled by neural and hormonal signals (1). In OAB, there can be involuntary contractions of DSM cells during the storage time of urine that results in leakage. There are strategies to reduce the complications of OAB that include life style changes (reduced fluid intake), acupuncture (2), and pharmacological therapy (8). For example, if one could pharmacologically target a specific protein channel involved in membrane potential function of DSM cells with a drug that results in relaxation of the DSM; this would be of great benefit.In this issue of the American Journal Physiology-Cell Physiology, Petkov and colleagues (5) provide a very exciting study in which they report a novel regulatory mechanism in the human urinary bladder in which the transient receptor potential melastatin 4 channel (TRPM4) is instrumental in human DSM excitability and contractility. The implications from their results suggest that TRPM4 may be a novel therapeutic target for ameliorating symptoms of OAB.TRPM4 is a Ca 2ϩ -activated nons...