Overactive bladder.

Abstract

Overactive bladder (OAB) is defined as urgency, with or without urge incontinence, usually with frequency and nocturia, in the absence of local pathological or hormonal factors. It is a common complaint of men and women alike, with estimates of 22 million sufferers. ApproximateLy 70% of men with bladder outflow obstruction will have some symptoms of OAB. The exact pathophysiology of OAB in bladder outflow obstruction is yet to be elucidated; evidence to date points to changes in both the efferent and afferent innervation and the detrusor. Management of OAB can be is generally with pharmacological agents such as anticholinergics or operative measures such as the 'Clam' cystoplasty. More recent treatment modalities include intravesicaL oxybutynin, intradetrusor botulinum toxin and neuromodulation. More specific treatment options for OAB in bladder outflow obstruction include relief of the obstruction with surgical (e.g. transurethraL resection of prostate) or pharmaceutical (e.g. a blockers) methods.