[Standard pharmacological treatment and new therapies for overactive bladder]

Urologia. 2012;79(1):6-13. doi: 10.5301/RU.2012.9032.
[Article in Italian]

Abstract

The prevalence of overactive bladder (OAB) in adult males varies from 10.2% to 17.4%, and in females from 7.7 to 31.3. 16.5% of the adult population presents symptoms consistent with OAB; of these, 37.2% are actually affected. The OAB has a significant effect on the quality of life. Initial treatment includes behavioral therapy, physiotherapy and antimuscarinic drugs. In patients where behavioral modifications fail, treatment is associated with antimuscarinics. The antimuscarinic agents used to treat OAB showed some efficacy, but adverse events too, such as dry mouth, constipation, headache and blurred vision. In selected cases unresponsive to antimuscarinic therapy, it is possible to use second-line treatments represented by sacral neuromodulation and botulinum toxin type A both for idiopathic detrusor overactivity, where it is still an experimental treatment, and for neurogenic cases with 2011 FDA approval. Surgical options represent the last choice for selected cases.

Publication types

  • Review

MeSH terms

  • Administration, Intravesical
  • Algorithms
  • Botulinum Toxins, Type A / administration & dosage
  • Botulinum Toxins, Type A / therapeutic use
  • Capsaicin / administration & dosage
  • Capsaicin / therapeutic use
  • Clinical Trials, Phase III as Topic
  • Combined Modality Therapy
  • Electric Stimulation Therapy
  • Female
  • Humans
  • Injections
  • Intermittent Urethral Catheterization
  • Lumbosacral Plexus / physiopathology
  • Male
  • Multicenter Studies as Topic
  • Muscarinic Antagonists / administration & dosage
  • Muscarinic Antagonists / adverse effects
  • Muscarinic Antagonists / therapeutic use*
  • Prevalence
  • Urinary Bladder, Overactive / drug therapy*
  • Urinary Bladder, Overactive / epidemiology
  • Urinary Bladder, Overactive / physiopathology
  • Urinary Bladder, Overactive / surgery
  • Urinary Bladder, Overactive / therapy

Substances

  • Muscarinic Antagonists
  • Botulinum Toxins, Type A
  • Capsaicin