Treatment of overactive bladder syndrome (OAB) should be two-fold. In the therapeutic process, both lifestyle modification and pharmacological management should be taken into account. The causes of OAB are not entirely clear. However, it is known that the disease can be the result of many pathological processes. This means that pharmacotherapy must be individually adapted to the needs of each patient.

Treatment of overactive bladder syndrome (OAB)is not at all simple. Currently, there is no one ideal drug that can be used in all people with OAB.Overactive bladderis a chronic disease that can be effectively controlled with rational therapy with modern drugs. Correct therapy should last long enough and be acceptable for the patient, i.e. the side effects should not be more burdensome than the disease itself (the most common side effects are: dry mouth, visual disturbances, gastrointestinal disturbances, impaired cognitive processes, headaches, heart rhythm disturbances, urine retention, worsening of peptic ulcer symptoms). Susceptibility to the occurrence of side effects depends on individual predispositions, therefore, patients should be given access to many medicinal substances.

Overactive bladder treatment: lifestyle modification

Treatment begins with the implementation of minimally invasive therapy, i.e. lifestyle modification. It is recommended to introduce pelvic floor (Kegel) exercises to reduce urgency and implement behavioral therapy:

  • bladder training by urinating at regular intervals - every 3-4 hours (patient
  • should increase the interval between micturitions by 30 minutes at weekly intervals), bladder training
  • is recommended for people of all ages;
  • keeping a voiding diary (measuring the frequency of voidings, time and volume);
  • changing the diet, restricting the consumption of caffeinated beverages, alcohol, carbonated drinks or
  • artificial sweeteners.

Pharmacological treatment of overactive bladder

Simultaneously or as a further treatment step, pharmacotherapy is recommended, which is currently considered the gold standard in the treatment of overactive bladder. Currently recommendeddrugs are based on active substances such as: oxybutynin, darifenacin, solifenacin, tolterodine, trospium, fesoteradine.

The therapy can be supplemented with other substances supporting treatment, e.g. tricyclic antidepressants with imipramine, doxepin, estrogens, drugs with adrenergic activity with tamsulosin, doxazosin, intravesical drugs with oxybutynin.

The main limitation in the use of anticholinergic preparations in the treatment of OAB are their frequent side effects, a large group of patients quit the therapy after only a few months of its use. Therefore, work on new, more effective and better tolerated medicinal substances is underway.

For people who have not been successful in the methods used so far, also combined (treatment with several methods), surgical treatment is recommended.

Important

A novelty in the pharmacological treatment of OAB and currently the only alternative to anticholinergic drugs is mirabegron, which is a beta-3-adrenergic receptor antagonist. Clinical trials have shown that this drug has a relatively high safety profile and moderate side effects. It is also highly effective in patients who did not respond to treatment with antimuscarinic drugs or struggled with severe side effects.

press materials of the Association of NTM People "UroConti"

Press materials

Category:

Urology and Nephrology