overactive bladder (OAB)
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Introduction
A condition characterized by involuntary detrusor contractions during the bladder filling phase, which may be spontaneous or provoked & which the patient cannot suppress. It may result in urge incontinence.
Etiology
- see urge incontinence
- see disorders contributing to overactive bladder & urge incontinence
- parasympathomimetics including cholinesterase inhibitors
- idiopathic
Epidemiology
affects men & women equally
Pathology
- spastic contraction of the detrusor muscle
- sustained high bladder pressure
Clinical manifestations
- urgency at inconvenient & unpredictable time
- urge incontinence
Complications
Management
- behavioral therapy alone is reasonable 1st step[8]
- pelvic-floor exercises & urge-suppression strategie
- drug therapy consist of antimuscarinic agent + alpha blocker
- antimuscarinic agents probably prevent a small number of urgency episodes & may improve quality of life[9]
- see urge incontinence
More general terms
More specific terms
Additional terms
References
- ↑ Prescriber's Letter 12(2): 2005 Antimuscarinic Medications for Overactive Bladder Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210209&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Prescriber's Letter 15(1): 2008 Chart: Antimuscarinic Medications for Overactive Bladder Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=240108&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Madhuvrata P, Cody JD, Ellis G, Herbison GP, Hay-Smith EJ. Which anticholinergic drug for overactive bladder symptoms in adults. Cochrane Database Syst Rev. 2012 Jan 18;1:CD005429. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22258963
- ↑ Novara G, Galfano A, Secco S et al A systematic review and meta-analysis of randomized controlled trials with antimuscarinic drugs for overactive bladder. Eur Urol. 2008 Oct;54(4):740-63. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18632201
- ↑ Anger JT, Weinberg A, Suttorp MJ et al. Outcomes of intravesical botulinum toxin for idiopathic overactive bladder symptoms: a systematic review of the literature. J Urol. 2010 Jun;183(6):2258-2264. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20400142
- ↑ Gormley EA, Lightner DJ, Faraday M et al Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol. 2015 May;193(5):1572-80. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25623739
Gormley EA, Lightner DJ, Burgio KL et al Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol. 2012 Dec;188(6 Suppl):2455-63. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23098785 - ↑ Maman K, Aballea S, Nazir J et al Comparative efficacy and safety of medical treatments for the management of overactive bladder: a systematic literature review and mixed treatment comparison. Eur Urol. 2014 Apr;65(4):755-65. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24275310
- ↑ 8.0 8.1 Burgio KL, Kraus SR, Johnson TM II et al Effectiveness of Combined Behavioral and Drug Therapy for Overactive Bladder Symptoms in Men. A Randomized Clinical Trial. JAMA Intern Med. Published online January 13, 2020. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31930360 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2758797
- ↑ 9.0 9.1 Stoniute A, Madhuvrata P, Still M et al Effectiveness of anticholinergic drugs for treating people with overactive bladder syndrome. Cochrane Library. 2023. May 9 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37160297 https://www.cochrane.org/CD003781/INCONT_effectiveness-anticholinergic-drugs-treating-people-overactive-bladder-syndrome