Reversing the tide: emerging options for treating overactive bladder symptoms in women

The symptom complex of urinary urgency, frequency, nocturia, and urge incontinence, also known as the "overactive bladder" syndrome, affects the lives of millions of American women. As the symptoms are nonspecific, several different etiologies may be responsible. In many women, however, no discernible source can be identified. If a basic evaluation, including history, physical examination, urinalysis, and postvoid residual determination, fails to identify a source for the complaints, empiric treatment with behavioral intervention or a trial of medication may be offered to control symptoms. Certain patients will require a more detailed evaluation, particularly if conservative measures fail to provide relief. The role of advanced diagnostic strategies and the emergence of new treatment modalities are discussed.