Evaluation and Treatment of Overactive Bladder in Women

Overactive bladder (OAB) is a symptom complex that includes urinary urgency, frequency, urgency incontinence, and nocturia. It is highly prevalent, affecting up to 12% of the adult population, and can significantly impact quality of life. The diagnosis of OAB is made by history, physical examination, and a urinalysis to rule out underlying infection or other concerning potential etiologies. The need for additional testing is based on the initial evaluation findings, and is recommended in cases of underlying urinary tract infection, microscopic hematuria, obstructive voiding symptoms, and symptoms refractory to previous treatments.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Concise review Source Type: research

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Overactive bladder syndrome (OAB) is defined by the International Continence Society (ICS) as a clinical syndrome characterized by urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology [1]. Its prevalence is higher in women than in men and increases with advancing age [2]. In Brazil, Moreira et al., in 2013, found a prevalence of OAB of 5.1% in males and 10% in females among adults, and in the elderly, a prevalence of 78% in males and 82% in females.
Source: Maturitas - Category: Primary Care Authors: Source Type: research
Conclusions: This meta-analysis indicated that BTX-A 200U and 300U are more effective than placebo in the treatment of NDO, with minimal, local, and manageable adverse events. Furthermore, BTX-A 300U and 200U could also improve detrusor compliance of IOAB. However, more RCTs would still be necessary to explore the effect of BTX-A on management of UI in NDO and IOAB patients.
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Abstract Overactive bladder (OAB) syndrome is a condition that involves urinary urgency, usually accompanied by increased daytime frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology. This condition is multifactorial, and several theories exist that explain the pathophysiologic process underlying the condition. Because the prevalence of the condition is high among women across all age groups, obstetrician-gynecologists will encounter women with OAB syndrome and should be able to evaluate and treat this condition. The appropriate ...
Source: Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Obstet Gynecol Source Type: research
In conclusion, limited evidence shows that routine urodynamics prior to non-surgical management of UI or surgical management of SUI is not associated with improved treatment outcomes, when compared to clinical evaluation only. Well-designed clinical trials are needed to evaluate the clinical and cost-effectiveness of routine urodynamics prior to surgical management of SUI and OAB.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
To ascertain whether a poor response and adverse events (voiding dysfunction and urinary tract infection) were predictable for first time botulinum toxin-A (BTX-A) injections in a patient cohort of refractory idiopathic overactive bladder with detrusor overactivity.
Source: Urology - Category: Urology & Nephrology Authors: Tags: Female Urology, Urodynamics, Incontinence, and Pelvic Floor Reconstructive Surgery Source Type: research
AbstractPurpose of ReviewIn this review, we aim to examine current literature focused on the effects of estrogen in causing conditions such as urinary incontinence, overactive bladder, recurrent urinary tract infections, pelvic organ prolapse, and anorectal dysfunction.Recent FindingsSmall studies have confirmed the role of local estrogen therapy in the treatment of overactive bladder and recurrent urinary tract infection.SummaryAlthough well recognized that the female lower urinary tract and pelvic floor are estrogen responsive, there is paucity in the role of estrogen status in causing such conditions.
Source: Current Bladder Dysfunction Reports - Category: Urology & Nephrology Source Type: research
ConclusionsApart from oxybutynin, other anticholinergics showed efficacy including an increase in mean voided volume. Moreover, there was no significant difference in the incidence of overall adverse events between anticholinergics and placebo.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
This study also found that Proteus DNA, a genus with many uropathogenic species (Drzewiecka, 2016), was more prevalent in women with OAB compared to asymptomatic controls (Curtiss et al., 2017). IC A recent study by Abernethy et al. suggested that the microbiome may play a role in IC (Abernethy et al., 2017). In this study, 16S rRNA analysis determined the microbiome of catheterized urine from women (n = 40) with IC was not dominated by a single genus and was less likely to contain Lactobacillus compared to asymptomatic women. Abernethy et al. also showed that L. acidophilus was associated with less severe scores on the ...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Kate V. Meriwether1*, Zhenmin Lei1, Rajbir Singh2, Jeremy Gaskins3, Deslyn T. G. Hobson1 and Venkatakrishna Jala2 1Department of Obstetrics and Gynecology, University of Louisville, Louisville, KY, United States 2Department of Microbiology and Immunology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States 3Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, United States Interstitial cystitis/bladder pain syndrome (ICBPS) may be related to an altered genitourinary microbiome. Our aim was to compare the vaginal and urinary microbiomes b...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Abstract In specialist urology clinics, 50 - 70 % of patients have chronic urological diseases such as recurrent urinary tract infections, a somatoform overactive bladder, adult and infantile enuresis, a chronic pelvic pain syndrome, and the psychosomatic form of post-prostatectomy incontinence. The 12-month prevalence of psychological disorders in the general adult population is 28 % 1. As many as 20 % of children and adolescents are found to have psychological abnormalities 2. These are frequently accompanied by somatoform symptoms, often consisting of a psychosomatic voiding disorder with a consecutiv...
Source: Aktuelle Urologie - Category: Urology & Nephrology Authors: Tags: Aktuelle Urol Source Type: research
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