Oral Pharmacologic Management of Overactive Bladder Syndrome: Where Do We Stand?

Eur Urol Focus. 2019 Nov;5(6):1112-1119. doi: 10.1016/j.euf.2018.03.011. Epub 2018 Apr 4.

Abstract

Overactive bladder syndrome (OAB) is a prevalent disorder with a significant impact on quality of life. Despite this high prevalence, there is significant underdiagnosis and undertreatment due to several barriers, including embarrassment, poor communication and low patient adherence. Currently, various antimuscarinic are available in the treatment of OAB. The introduction of mirabegron has broadened the therapeutic approach and combination therapy of both agents can be valuable in clinical practice. Yet, patient adherence to most drugs for OAB is still relatively poor. Healthcare providers need to identify and utilise strategies to improve treatment adherence by defining clear treatment goals, implement educational methods and frequently communicate with patients to identify problems with adherence. The elderly population form need special attention as in these patients, anticholinergics should be prescribed with care and adequate knowledge regarding pharmacokinetics and drug interactions in essential. Furthermore, patient expectations should be clearly discussed. In this narrative review, the current advances in oral pharmacotherapy are evaluated and the most important factors involved in the management of OAB are discussed.

Keywords: Drug; Incontinence; Medication; Overactive bladder syndrome; Pharmacology; Urgency.

Publication types

  • Review

MeSH terms

  • Acetanilides / administration & dosage*
  • Acetanilides / adverse effects
  • Acetanilides / therapeutic use*
  • Administration, Oral
  • Adrenergic beta-3 Receptor Agonists / administration & dosage*
  • Adrenergic beta-3 Receptor Agonists / adverse effects
  • Adrenergic beta-3 Receptor Agonists / therapeutic use*
  • Aged
  • Case-Control Studies
  • Cholinergic Antagonists / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Mandelic Acids / administration & dosage
  • Mandelic Acids / adverse effects
  • Mandelic Acids / therapeutic use
  • Middle Aged
  • Muscarinic Antagonists / administration & dosage
  • Muscarinic Antagonists / adverse effects
  • Muscarinic Antagonists / therapeutic use
  • Patient Compliance / statistics & numerical data
  • Prevalence
  • Quality of Life
  • Thiazoles / administration & dosage*
  • Thiazoles / adverse effects
  • Thiazoles / therapeutic use*
  • Urinary Bladder, Overactive / drug therapy*
  • Urinary Bladder, Overactive / epidemiology
  • Urinary Bladder, Overactive / psychology

Substances

  • Acetanilides
  • Adrenergic beta-3 Receptor Agonists
  • Cholinergic Antagonists
  • Mandelic Acids
  • Muscarinic Antagonists
  • Thiazoles
  • oxybutynin
  • mirabegron