Overactive bladder syndrome: Management and treatment options

Aust J Gen Pract. 2020 Sep;49(9):593-598. doi: 10.31128/AJGP-11-19-5142.


Background: Overactive bladder (OAB) is a common syndrome in the community characterised by unstable bladder contractions, resulting in urinary urgency, frequency and nocturia in the absence of detectable disease. Large studies suggest that >10% of the general population is symptomatic.

Objective: The aim of this article is to summarise the stepwise treatment for OAB that seeks to improve patient quality of life and reduce patient and health system costs.

Discussion: OAB is a diagnosis of exclusion that begins with a targeted history and examination of the urogenital system with the aim of assessing the burden of disease on the patient. First-line treatment comprises conservative measures including weight reduction, a decrease in exposure to bladder stimulants, fluid optimisation and pelvic floor exercises. Pharmacological treatments for OAB include anticholinergic medications such as oxybutynin. If the patient is unresponsive to pharmacological treatment, a review by a urology specialist is appropriate. Recommendations may include minimally invasive procedures such as intravesical botulinum toxin A injections, reserving the invasive procedures for patients in specific circumstances.

MeSH terms

  • Disease Management
  • Humans
  • Primary Health Care / methods
  • Quality of Life / psychology
  • Urinary Bladder, Overactive / drug therapy
  • Urinary Bladder, Overactive / therapy*