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Overactive bladder

All articles from this key word are listed below.

Volume 10, Number 1 Meeting Reviews

Neurourology, Diet, and Painful Bladder

Meeting Review

Hann-Chorng Kuo Yao-Chi Chuang Michael B Chancellor

Highlights of the 37th Annual Conference of the International Continence Society, August 20-24, 2007, Rotterdam, Netherlands [Rev Urol. 2008;10(1):70-72]

Overactive bladder Interstitial cystitis Diet Comorbidities Painful bladder syndrome Sensory nerve testing

Volume 11, Number 2 Review Articles

Will the Evolution of Overactive Bladder Delivery Systems Increase Patient Compliance?

Treatment Review

Nirit Rosenblum

The negative impact of overactive bladder (OAB) on daily quality of life drives the large market of pharmacotherapy targeted at symptoms of urinary frequency and urgency, with or without urinary urge incontinence. Currently, the primary pharmacologic treatment modality is aimed at modulation of the efferent muscarinic receptors (M2 and M3) predominant in detrusor smooth muscle and responsible for involuntary or unwanted bladder contractions. However, due to drug effects in the muscarinic receptors of the salivary glands and intestinal smooth muscle, as well as extensive first-pass metabolism in the liver and intestinal tract yielding parent drug metabolites, adverse side effects are common and can be quite bothersome. These issues, encountered with many of the oral antimuscarinic formulations, limit their tolerability and affect long-term patient compliance and satisfaction. Thus, the benefit of pharmacotherapy for OAB must be a balance between efficacy and tolerability, also known as therapeutic index. This article reviews the current pharmacologic delivery systems available for the treatment of OAB, patient compliance, and reasons for discontinuation of medication.[Rev Urol. 2009;11(2):45-51]

Overactive bladder Pharmacotherapy Compliance Antimuscarinic agent

Volume 12, Number 3 Review Articles

Can Urinary Nerve Growth Factor Be a Biomarker for Overactive Bladder?

Diagnostic Update

Hann-Chorng Kuo Hsin-Tzu Liu Michael B Chancellor

The clinical diagnosis of overactive bladder (OAB) greatly varies and is based on subjective symptoms. A more objective method to diagnose and assess therapeutic outcome in OAB patients, especially for health care providers not trained in urology, needs to be found. Evidence has shown that urinary proteins such as nerve growth factor (NGF) and prostaglandin E2 levels increase in patients with OAB, bladder outlet obstruction, and detrusor overactivity. Urinary NGF level increases physiologically in normal subjects at urge to void, but increases pathologically in OAB patients at a small bladder volume and with a sensation of urgency. Recent studies have shown that patients with OAB dry and OAB wet have significantly higher urinary NGF levels compared with control groups and patients with increased bladder sensation. Urinary NGF levels decrease after antimuscarinic therapy and further decrease after detrusor botulinum toxin injections in refractory OAB. Urinary NGF level could be a potential biomarker for diagnosis of OAB and assessment of the therapeutic effect of antimuscarinic therapy. The latest medical advances in this field are reviewed herein. [Rev Urol. 2010;12(2/3):e69-e77 doi: 10.3909/riu0432]

Biomarkers Overactive bladder Urinary proteins Nerve growth factor

Volume 12, Number 1 Review Articles

A Comparative Review of Oxybutynin Chloride Formulations: Pharmacokinetics and Therapeutic Efficacy in Overactive Bladder

Treatment Update

Michael J Kennelly

Antimuscarinic agents remain the mainstay of treatment of overactive bladder. However, the utility of some of these agents is limited due to tolerability concerns, multiple daily dosage regimens, lack of formulary coverage, and high cost. This can lead to problems with long-term compliance and may preclude optimal management. Oxybutynin has been the most widely prescribed antimuscarinic agent for more than 30 years. To meet the needs of tolerability and compliance, oxybutynin has evolved from an immediate-release pill to a once-daily oral dose and is now available as a topical gel. This review compares the various oxybutynin formulations in terms of pharmacokinetics, efficacy, and tolerability issues.[Rev Urol. 2010;12(1):12-19 doi: 10.3909/riu0484]

Overactive bladder Urge incontinence Oxybutynin N-desethyloxybutynin

Volume 15, Number 3 Review Articles

Use of Herbal Supplements for Overactive Bladder

Management Update

Richard Lee Bilal Chughtai Alexis E Te Elizabeth Kavaler Franklin C Lowe Steven A Kaplan

Anticholinergics, specifically antimuscarinic agents, are the most common medications prescribed for overactive bladder (OAB). The most common side effects of these agents are dry mouth and constipation, although other more concerning effects include changes in blood pressure, pulse rate, or heart rhythm when treatment is initiated. Herbal treatments are an increasingly popular alternative for treating OAB. A 2002 survey of US adults aged ≥ 18 years conducted by the Centers for Disease Control and Prevention indicated that 74.6% of those with OAB had used some form of complementary and alternative medicine. The World Health Organization estimates that 80% of the world’s population presently uses herbal medicine for some aspect of primary health care. Women were more likely than men to use complementary and alternative medicine. The authors review the most commonly used herbal medications for OAB. [Rev Urol. 2013;15(3):93-96 doi: 10.3909/riu0587] © 2013 MedReviews®, LLC

Overactive bladder Herbal medicine Gosha-jinki-gan Hachi-mi-jio-gan Buchu (Barosma betuline)Cleavers (Galium aparine)Cornsilk (Zea mays)Horsetail (Equisetum)Ganoderma lucidum Resinferatoxin Capsaicin

Volume 15, Number 2 Meeting Reviews

Best of the 2013 AUA Annual Meeting

Highlights From the 2013 American Urological Association Meeting, May 4-8, 2013, San Diego, CA

Prostate cancer PSA screening Nephrolithiasis Overactive bladder PCA3 Interstitial cystitis Prostate biopsy Transrectal ultrasound Erectile dysfunction Cystectomy Chronic pelvic pain syndrome Shock wave lithotripsy Prostate markers

Volume 15, Number 1 Review Articles

The Other Bladder Syndrome: Underactive Bladder

Management Review

Minoru Miyazato Naoki Yoshimura Michael B Chancellor

Detrusor underactivity, or underactive bladder (UAB), is defined as a contraction of reduced strength and/or duration resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emptying within a normal time span. UAB can be observed in many neurologic conditions and myogenic failure. Diabetic cystopathy is the most important and inevitable disease developing from UAB, and can occur silently and early in the disease course. Careful neurologic and urodynamic examinations are necessary for the diagnosis of UAB. Proper management is focused on prevention of upper tract damage, avoidance of overdistension, and reduction of residual urine. Scheduled voiding, double voiding, al-blockers, and intermittent self-catheterization are the typical conservative treatment options. Sacral nerve stimulation may be an effective treatment option for UAB. New concepts such as stem cell therapy and neurotrophic gene therapy are being explored. Other new agents for UAB that act on prostaglandin E2 and EP2 receptors are currently under development. The pharmaceutical and biotechnology industries that have a pipeline in urology and women’s health may want to consider UAB as a potential target condition. Scientific counsel and review of the current pharmaceutical portfolio may uncover agents, including those in other therapeutic fields, that may benefit the management of UAB. [Rev Urol. 2013;15(1):11-22 doi: 10.3909/riu0558] © 2013 MedReviews®, LLC

Underactive bladder Overactive bladder Detrusor overactivity Diabetic cystopathy

Volume 18, Number 3 Meeting Reviews

Highlights From the 2016 American Urological Association Annual Meeting

Michael A Gorin Michael K Brawer J Curtis Nickel Benjamin M Brucker Dean G Assimos Ellen Shapiro Alan W Partin Michael B Chancellor Stacy Loeb

More than 2000 posters, abstracts, and videos were presented at the 2016 American Urological Association (AUA) Annual Meeting, held in San Diego, CA, from May 6 to 10, 2016. The editors of Reviews in Urology have culled an enormous volume of information from this premier source and present the findings that are most relevant to the practicing urologist. [Rev Urol. 2016;18(3):159-173 doi:10.3909/riu0717] © 2016 MedReviews®, LLC

Prostate cancer Active surveillance Disorders of sexual development Nephrolithiasis Overactive bladder Microbiome OnabotulinumtoxinA Hemorrhagic cystitis Inflammation Four kallikrein assay Genomic prostate score

Volume 18, Number 1 Review Articles

Falls in the Elderly Secondary to Urinary Symptoms

Prevention and Management Update

Yousef Soliman Richard Meyer Neil Baum

Falls and fractures have a significant impact on our patients, their families, and caregivers, and cost the health care system billions of dollars. Each year, millions of adults aged 65 and older fall. Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable. Because many patients with falls and subsequent fractures have urologic conditions, urologists are positioned to help with the prevention of these significant and costly injuries. This article discusses the epidemiology of falls and fractures, and the urologic comorbidities that increase their risk. [Rev Urol. 2016;18(1):28-32 doi: 10.3909/riu0686] © 2016 MedReviews®, LLC

Nocturia Overactive bladder Falls Fractures Urinary tract infections Prevention

Volume 20, Number 1 Review Articles

Nocturia: Evaluation and Current Management Strategies

Management Update

Roger R Dmochowski W Stuart Reynolds Alan J Wein Casey G Kowalik Joshua A Cohn Sophia Delpe Melissa R Kaufman Doug F Milam

Nocturia is a complex condition that not only significantly affects quality of life, but may be an indicator of systemic disease. Initial assessment includes a detailed history and physical examination and completion of a frequency volume chart to help identify underlying causes, such as sleep disorders, bladder storage disorders, and polyuria. Treatment with alpha-blockers or antimuscarinic medications may help if the underlying cause is determined to be benign prostatic hyperplasia or overactive bladder, respectively. Treatment options for nocturnal polyuria have been limited to behavioral therapy and off-label use of timed diuretics and desmopressin. Desmopressin acetate nasal spray (Noctiva™, Avadel Pharmaceuticals, Chesterfield, MO) was approved by the US Food and Drug Administration in 2017 for the treatment of nocturia due to nocturnal polyuria in adults who awaken at least twice nightly and has shown efficacy in reducing nocturnal voids by $50% in up to 49% of patients in clinical trials. [Rev Urol. 2018;20(1):1–6 doi: 10.3909/riu0797] © 2018 MedReviews®, LLC

Benign prostatic hyperplasia Nocturia Desmopressin Nocturnal polyuria Overactive bladder