Evaluating current management of overactive bladder syndrome

This study reviewed the current management for overactive bladder in a real-world setting. The authors concluded that behavioral therapy and antimuscarinic drugs were the preferred therapies, corresponding to guideline recommendations. 

Overactive bladder (OAB) occurs when the bladder muscle is too active. Instead of staying at rest as urine fills the bladder, the bladder contracts. This causes a person to feel a sudden and sometimes overwhelming urge to urinate even when the bladder is not full. Treatments for OAB can include antimuscarinics such as tolterodine (Detrol), oxybutynin (Ditropan) and beta-3 adrenergic agonists such as mirabegron (Myrbetriq) or behavioral therapy. 

It is unclear which treatment is better and preferred in real-world medical practice.

This study included 507 patients (394 female and 113 male) with OAB. They were evaluated with questionnaires.

First line treatment included behavioral therapy and bladder diaries. Behavioral therapy was recommended to 73.2% of female and 81.4% of male patients. 

In the first visit, 86.1% of the female and 89.3% of the male patients were given antimuscarinic medications. Side-effects occurred in 94.4% of female patients and 88.9% of male patients. These include dry mouth, dry skin, and blurred vision. However, few patients (1.7% female and 4.8% male) changed medications due to these side-effects. 

Despite guideline recommendations, bladder diaries were not used in half of the patients. 

This review found that behavioral therapy and antimuscarinics were the preferred initial treatments of OAB.

This study had a very short follow-up period of 4 months. Also, many patients did not return to follow-up visits. This might have changed the results.