Update on Management of Overactive Bladder

AbstractPurpose of ReviewOveractive bladder (OAB) is an extremely common condition with rising incidence and increasing economic and quality-of-life burdens. Management is rapidly and constantly evolving, and this review aims to discuss recent developments in context to achieve a comprehensive overview of modern OAB treatment options.Recent FindingsThis review focuses on growing evidence for the efficacy of conservative measures including pelvic physical floor therapy and lifestyle modification. We also discuss recent developments in pharmacology that are reshaping the treatment landscape for patients refractory to first-line measures. Key examples are the novel β3 agonists vibegron and solabegron, as well as experimental therapies such as transient receptor potential inhibitors. We then discuss historical and novel neuromodulation modalities including implantable tibial nerve stimulators and pudendal nerve stimulation for appropriately selected patients.SummaryOAB is a symptom complex consisting of urinary urgency, frequency, nocturia, and urgency urinary incontinence in the absence of contributing pathologic diagnosis such as urinary tract infection. OAB management is complex and involves escalating tiers of therapy progressing from lifestyle modification to pharmacotherapy and then to more invasive interventions including botulinum toxin injections, neuromodulation, and ultimately to last-resort therapies including bladder augmentation or urinary diversion. The quality-of...
Source: Current Surgery Reports - Category: Surgery Source Type: research