State of the science: pathology and management of the patient with overactive bladder

A relatively new term, overactive bladder is used to describe urinary frequency, urgency, and nocturia with or without urinary incontinence. Normal micturition involves coordination among the nervous system, the bladder, and the sphincter. Theories about pathogenesis include disorders of the central and peripheral nervous system, lowered levels of neurotransmitters, and structural problems of the bladder and sphincter. Assessing the patient with overactive bladder incorporates a thorough history and focused physical exam. Current treatments for this condition include lifestyle changes, behavioral interventions, pharmacologic management, and neuromodulation therapy. Research into different medications and delivery systems proves promising for the patient with overactive bladder.