title: Overactive bladder - 18 years - Part II.
abstract: Traditionally, the treatment of overactive bladder syndrome has been based on the use of oral medications with the purpose of reestablishing the detrusor stability. The recent better understanding of the urothelial physiology fostered conceptual changes, and the oral anticholinergics - pillars of the overactive bladder pharmacotherapy - started to be not only recognized for their properties of inhibiting the detrusor contractile activity, but also their action on the bladder afference, and therefore, on the reduction of the symptoms that constitute the syndrome. Beta-adrenergic agonists, which were recently added to the list of drugs for the treatment of overactive bladder, still wait for a definitive positioning - as either a second-line therapy or an adjuvant to oral anticholinergics. Conservative treatment failure, whether due to unsatisfactory results or the presence of adverse side effects, define it as refractory overactive bladder. In this context, the intravesical injection of botulinum toxin type A emerged as an effective option for the existing gap between the primary measures and more complex procedures such as bladder augmentation. Sacral neuromodulation, described three decades ago, had its indication reinforced in this overactive bladder era. Likewise, the electric stimulation of the tibial nerve is now a minimally invasive alternative to treat those with refractory overactive bladder. The results of the systematic literature review on the oral pharmacological treatment and the treatment of refractory overactive bladder gave rise to this second part of the review article Overactive Bladder - 18 years, prepared during the 1st Latin-American Consultation on Overactive Bladder.
authors.affiliation: Escola Paulista de Medicina - EPM - Universidade Federal de São Paulo, SP, Brasil.
authors.forename: Jose Carlos
authors.initials: JC
authors.lastname: Truzzi
authors.affiliation: Departamento de Urologia, Universidade de São Paulo, SP, Brasil.
authors.forename: Cristiano Mendes
authors.initials: CM
authors.lastname: Gomes
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, SP, Brasil.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Bezerra
authors.affiliation: Departamento de Urología, Universidad de los Andes, Bogota, Colombia.
authors.forename: Ivan Mauricio
authors.initials: IM
authors.lastname: Plata
authors.affiliation: Departamento de Urología, Escuela Médico Militar, Cidade do México, Mexico.
authors.forename: Jose
authors.initials: J
authors.lastname: Campos
authors.affiliation: Cátedra de Urologia, Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina.
authors.forename: Gustavo Luis
authors.initials: GL
authors.lastname: Garrido
authors.affiliation: Escola Paulista de Medicina - EPM - Universidade Federal de São Paulo, SP, Brasil.
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Almeida
authors.affiliation: Departamento de Urologia, Mãe de Deus Center Hospital, Porto Alegre, RS, Brasil.
authors.forename: Marcio Augusto
authors.initials: MA
authors.lastname: Averbeck
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Fornari
authors.affiliation: Departamento de Urologia, AC Camargo Hospital, SP, Brasil.
authors.forename: Anibal
authors.initials: A
authors.lastname: Salazar
authors.affiliation: Hospital Clinico de la Fuerza Area de Chile, Santiago, Chile.
authors.forename: Arturo
authors.initials: A
authors.lastname: Dell'Oro
authors.affiliation: Departamento de Urologia, Faculdade de Medicina do ABC, SP, Brasil.
authors.forename: Caio
authors.initials: C
authors.lastname: Cintra
authors.affiliation: Departamento de Urologia, AC Camargo Hospital, SP, Brasil.
authors.forename: Carlos Alberto Ricetto
authors.initials: CA
authors.lastname: Sacomani
authors.affiliation: Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Tapia
authors.affiliation: Departamento de Urologia, Hospital Souza Aguiar, RJ, Brasil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Brambila
authors.affiliation: Servicio de Urología, del Complejo Médico Policial Churruca Visca, Buenos Aires, Argentina.
authors.forename: Emilio Miguel
authors.initials: EM
authors.lastname: Longo
authors.affiliation: Departamento de Urologia, Universidade de São Paulo, SP, Brasil.
authors.forename: Flavio Trigo
authors.initials: FT
authors.lastname: Rocha
authors.affiliation: Departamento de Urologia, Hospital Souza Aguiar, RJ, Brasil.
authors.forename: Francisco
authors.initials: F
authors.lastname: Coutinho
authors.affiliation: Centro Policlínico Valencia "La Viña", Valencia, Venezuela.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Favre
authors.affiliation: Centro Policlínico Valencia "La Viña", Valencia, Venezuela.
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Garcia
authors.affiliation: Hospital Pablo Tobón Uribe, Medellin, Colômbia.
authors.forename: Juan
authors.initials: J
authors.lastname: Castano
authors.affiliation: Departamento de Urologia, Hospital Souza Aguiar, RJ, Brasil.
authors.forename: Miguel
authors.initials: M
authors.lastname: Reyes
authors.affiliation: Servicio de Urología, Clinica Indisa, Providencia, Chile.
authors.forename: Rodrigo Eugenio
authors.initials: RE
authors.lastname: Leyton
authors.affiliation: Centro de Reabilitação e Readaptação Dr. Henrique Santillo, Goiânia, Brasil.
authors.forename: Ruiter Silva
authors.initials: RS
authors.lastname: Ferreira
authors.affiliation: Departamento de Urologia, Hospital Souza Aguiar, RJ, Brasil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Duran
authors.affiliation: Servicio de Urología, del Hospital Universitario de Caracas, Caracas, Venezuela.
authors.forename: Vanda
authors.initials: V
authors.lastname: Lopez
authors.affiliation: Divisão de Urologia, Universidade Federal do Ceará, CE, Brasil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Reges
mesh_terms: D000284:Administration, Oral; D058667:Adrenergic beta-3 Receptor Agonists / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000628:therapy*
chemical_list: D058667:Adrenergic beta-3 Receptor Agonists; D018727:Muscarinic Antagonists; D001905:Botulinum Toxins