The clinical pharmacology of the medical treatment for overactive bladder in adults

Expert Rev Clin Pharmacol. 2020 Jul;13(7):707-720. doi: 10.1080/17512433.2020.1779056. Epub 2020 Jun 16.

Abstract

Introduction: Overactive bladder is a prevalent symptom complex that affects the patient's quality of life. Any disruption between the neuronal micturition pathway can lead to bladder overactivity. Neurogenic causes, myogenic causes, aging, bladder outlet obstruction, sex, and psychological factors are some of the factors contributing to bladder overactivity. The complaint of any symptoms of OAB, which is highly prevalent and affects overall QOL, often needs therapeutic interventions. When conservative therapy methods fail, the addition of medications is recommended. The most commonly used agents for the treatment of OAB are antimuscarinic drugs. New classes of drugs, such as beta-3 agonists, have enriched our pharmacologic armamentarium.

Areas covered: In this review, with a special focus on oral pharmacological treatments, we discussed the definition, etiology, symptoms, diagnosis, and management of OAB.

Expert opinion: OAB is a multifactorial condition with every patient presenting with a different collection of symptoms and signs. Medical therapies should be given in conjunction with behavioral therapies. Using high or low doses, flexible doses, and stopping or changing the medications are interchangeable strategies based on the level of treatment efficacy and patient satisfaction.

Keywords: Pharmacotherapy; antimuscarinics; botulinum toxin-A; medical treatment; overactive bladder; β-adrenoceptor agonists.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Adrenergic beta-3 Receptor Agonists / administration & dosage*
  • Adrenergic beta-3 Receptor Agonists / pharmacology
  • Adult
  • Animals
  • Humans
  • Muscarinic Antagonists / administration & dosage*
  • Muscarinic Antagonists / pharmacology
  • Quality of Life
  • Urinary Bladder, Overactive / diagnosis
  • Urinary Bladder, Overactive / drug therapy*
  • Urinary Bladder, Overactive / physiopathology

Substances

  • Adrenergic beta-3 Receptor Agonists
  • Muscarinic Antagonists