Update on the treatment of overactive bladder

As overactive bladder (OAB) is a prevalent and chronic medical condition that greatly impacts an individual's quality of life, novel therapeutic options are always welcome.

Recent evidence suggests that newer antimuscarinic agents are not only superior to placebo, but may also have a role in treating OAB symptoms in children and men with lower urinary tract symptom. Dose escalation for trospium and fesoterodine has shown to be both efficacious and safe. Adverse events typically exceed those of placebo but infrequently lead to cessation of therapy. Long-term outcomes of sacral nerve stimulation for refractory OAB have been recently reported. Although the overall satisfaction with this therapy is high, more than 50% may experience chronic pain; however, this adverse event also does not frequently lead to device removal. Percutaneous tibial nerve stimulation continues to display superiority to sham treatment and benefits similar to antimuscarinic therapy may be observed. This therapy is well tolerated and durable outcomes have been seen at 12 months of follow-up. Recent evidence suggests that a dose of 100 U per botulinum neurotoxin type A injection may optimally balance symptom improvement and incidence of voiding difficulty.

Treatment modalities for OAB continue to evolve and the abundance of options can only benefit the individuals with this condition.