Overactive Bladder

A symptom syndrome that includes urgency, with or without urge incontinence, usually with frequency and nocturia

Aetiology

  • Usually caused by bladder (detrusor) overactivity
  • Affects 40% of the population >40 years in Europe

Management

  • Behavioural modification - modify fluid intake, avoid stimulants, bladder training
  • Pelvic floor exercises, biofeedback, acupuncture and electrical stimulation therapy may help
  • Medications:
    • Anticholinergic medication e.g. tolterodine (inhibit contraction)
    • β-adrenoceptor agonists (induce detrusor relaxation)
  • Options for failed conventional therapy:
    • Intravesical Botulinum toxin-A
    • Neuromodulation
    • Augmentation 'clam' ileocystoplasty
    • Ileal conduit urinary diversion