Overactive bladder.
The overactive bladder is a common condition, which has significant effects on quality of life. The aetiology in most cases is unknown, and treatment outcomes have until recently been unsatisfactory. Management includes excluding pathology and implementing behavioural changes such as caffeine reduction, bladder and pelvic floor training, as well as antimuscarinic drug therapy. Compliance is often problematic, and this can be improved with some of the newer antimuscarinics with fewer side-effects, and a good therapist/patient relationship. In the majority of cases this 'treatment package' is successful, but in those where it is not, intravesical therapies have been introduced, e.g. neuromodulation, alternative drug therapies (e.g. vanilloids, botox) and surgery. With a better understanding of the aetiology and identification of risk factors better outcomes from treatment are likely.
Freeman
R M
RM
Urogynaecology Unit, Directorate of Obstetrics and Gynaecology, Derriford Hospital, Plymouth PL6 8DH, UK. robert.freeman@phnt.swest.nhs.uk
Adekanmi
O A
OA
D001521:Behavior Therapy / Q000379:methods; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D004599:Electric Stimulation Therapy / Q000379:methods; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009119:Muscle Contraction; D010349:Patient Compliance; D017773:Pelvic Floor / Q000503:physiopathology; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D009626:Terminology as Topic; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery
D018680:Cholinergic Antagonists; D004967:Estrogens