[Overactive bladder--treatment with antimuscarinic agents]

Today, urgency and urge incontinence are both defined under the topic overactive bladder (OAB) whereby pure urge syndrome (pollakisuria, nocturia, and urgency) can easily lead to urge incontinence. Antimuscarinics still constitute the domain of treatment for overactive bladder. The pharmacological effect of modern substances consists of M2 or M3 muscarinic receptor blockade. This blockade prevents acetylcholine from connecting to these receptors and thus leads to a weakness or prevention of the detrusor muscle contraction. These groups of drugs are defined as muscarinic receptor antagonists, antimuscarinics, or anticholinergics. In addition to the muscarinic receptors, some drugs directly block the calcium channels in the cell membrane (calcium antagonists) which are classified as drugs with mixed effect. The presented paper gives an overview about the existing data on drugs approved in Germany whose clinical effect has been proven in randomized studies or are have stood the test of time in daily clinical practice.