Developments in the pharmacotherapy of the overactive bladder.
OBJECTIVE
The overactive bladder is a common and distressing condition that has a significant impact on the quality of life of many people worldwide. Anticholinergics remain the first line in pharmacotherapy, however the use of these agents is hindered by adverse effects and limited efficacy. Thus there is a need for more effective treatments. Recently, there has been a move towards targeting novel pathways thought to play a role in overactivity. This review aims to provide an insight into the recent developments in pharmacotherapy of the overactive bladder.


RESULTS
With recent advances in our understanding of the basic science of the overactive bladder it is becoming clear that the control of bladder functioning is far more complex than previously believed. Peripherally, a prominent role has emerged for the urothelium and the underlying suburothelium in mechanosensory control, and the role of afferent pathways in pathophysiology is increasingly recognized.


CONCLUSIONS
Recent research has highlighted several potential targets for treatment of the overactive bladder, particularly within the mechanosensory pathways. With the exception of botulinum toxin, however, few new therapies have emerged showing clinical benefits. A clearer understanding of the pathophysiology of the bladder will hopefully lead to more effective and tolerated treatments.
Sellers
Donna J
DJ
Biomedical Research Centre, Sheffield Hallam University, Sheffield, UK. d.j.sellers@shu.ac.uk
McKay
Neil
N
D058668:Adrenergic alpha-1 Receptor Antagonists; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002211:Capsaicin / Q000627:therapeutic use; D006801:Humans; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D015221:Potassium Channels / Q000187:drug effects; D050916:TRPV Cation Channels / Q000819:agonists; D015320:Tachykinins / Q000627:therapeutic use; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000187:drug effects* / Q000294:innervation / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy* / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000503:physiopathology
D058668:Adrenergic alpha-1 Receptor Antagonists; D000318:Adrenergic beta-Agonists; D000319:Adrenergic beta-Antagonists; D018727:Muscarinic Antagonists; D015221:Potassium Channels; D050916:TRPV Cation Channels; C494484:TRPV1 receptor; D015320:Tachykinins; D019274:Botulinum Toxins, Type A; D002211:Capsaicin