Treatment of overactive bladder symptoms beyond antimuscarinics: current and future therapies.
Overactive bladder (OAB) is a common syndrome that affects both men and women. First-line therapies for the management of OAB symptoms consist of antimuscarinic agents and behavioral therapy, ideally used in combination. Although effective in improving OAB symptoms, the use of antimuscarinic therapy may be limited by side effects, contraindications, and insufficient response. Current second-line therapies include sacral nerve stimulation and percutaneous tibial nerve stimulation. These therapies have been shown to be useful in treating OAB symptoms, but are more invasive and time-consuming than medical therapy. Onabotulinum toxin A is currently under investigation for idiopathic OAB, as well as the β-3-adreno-renoreceptor agonists mirabegron and solabegron. The role of these agents, with different mechanisms of action, in the pharmacologic management of OAB remains to be determined, although they appear to be promising alternatives and possible adjuncts to current pharmacologic and behavioral therapy. This article discusses second-line and current and future therapies for the management of OAB symptoms.
Division of Urology, Warren Alpert School of Medicine/Brown University, Providence, RI 02905, USA. pamelaellsworth@aol.com
Pamela
P
Ellsworth
D000083:Acetanilides / Q000627:therapeutic use; D058667:Adrenergic beta-3 Receptor Agonists / Q000627:therapeutic use; D000814:Aniline Compounds / Q000627:therapeutic use; D001521:Behavior Therapy; D001565:Benzoates / Q000627:therapeutic use; D001713:Biphenyl Compounds; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D009465:Neuromuscular Agents / Q000627:therapeutic use; D012447:Sacrum / Q000294:innervation; D013844:Thiazoles / Q000627:therapeutic use; D013979:Tibial Nerve; D053201:Urinary Bladder, Overactive / Q000628:therapy*
D000083:Acetanilides; D058667:Adrenergic beta-3 Receptor Agonists; D000814:Aniline Compounds; D001565:Benzoates; D001713:Biphenyl Compounds; D018727:Muscarinic Antagonists; D009465:Neuromuscular Agents; D013844:Thiazoles; C523977:solabegron; D019274:Botulinum Toxins, Type A; C520025:mirabegron