Overactive bladder: a better understanding of pathophysiology, diagnosis and management.

PURPOSE: We reviewed current information regarding the updated definitions, prevalence, etiologies, disease burden, and management of OAB from a number of perspectives, including professional impact and patient quality of life.

MATERIALS AND METHODS: Published literature and current treatment concepts were reviewed regarding the understanding and management of OAB.

RESULTS: OAB is a symptom syndrome including urinary urgency with or without urinary incontinence, usually with frequency and nocturia. Approximately 17% of the adult population experience OAB. There are evolving theories regarding its pathophysiology and the mechanism of action of the most commonly prescribed pharmacological therapy (antimuscarinic agents). Treatment primarily revolves around improving quality of life.

CONCLUSIONS: Behavioral therapy combined with pharmacological therapy often will bring about acceptable outcomes for patients with OAB. Modalities such as botulinum toxin injections, neuromodulation, and various surgical interventions also are showing encouraging results in more refractory patients.