Abstract
Overactive bladder (OAB) is defined by ICS as urinary urgency, usually accompanied
by increased daytime frequency and/or nocturia, with urinary incontinence (OAB-wet)
or without (OAB-dry), in the absence of urinary tract infection or other detectable
disease. OAB is a symptom-based diagnosis with tools such as bladder diaries assisting
in the diagnosis.
Cystoscopy and urodynamic studies are not required prior to starting non-surgical
treatment options (unless there are red flags). First line treatments are lifestyle
modifications and bladder retraining. Anticholinergic drugs are the recommended first
line medications, but clinicians must be mindful of the anticholinergic burden of
a patients’ cumulative medications. Beta-adrenoceptor agonists should be used as second-line
agents. For refractory OAB Botulinum toxin A can be used. Neuromodulation is an increasingly
popular and available treatment option for patients with refractory OAB symptoms.
More complex reconstructive surgery is reserved for the most resistant cases.
Keywords
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Further reading
- Systematic review of overactive bladder therapy in females.Can Urol Assoc J. 2011 Oct; 5 (PMID: 21989527; PMCID: PMC3193389): S139-S142https://doi.org/10.5489/cuaj.11185
https://www.baus.org.uk/_userfiles/pages/files/Patientss/Leaflets/OAB%20options.pdf.
https://www.nhs.uk/conditions/urinary-incontinence/treatment/.
- Overactive bladder syndrome: evaluation and management.Curr Urol. 2018 Mar; 11 (Epub 2018 Feb 20. PMID: 29692690; PMCID: PMC5903463): 117-125https://doi.org/10.1159/000447205
- Urinary Incontinence in patients: management.NICE Guideline, 2013 (CG 171)
Urinary Incontinence – BMJ masterclasses primary care general update.
Article info
Publication history
Published online: January 05, 2023
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