Drug therapy for overactive bladder

Overactive bladder is a syndrome with a significant worldwide prevalence and economic impact on health resources. With ageing populations, the health burden of this condition that is more common in older people, is likely to increase. Following conservative therapies, medical management of overactive bladder is the mainstay of treatment, usually with antimuscarinic therapy. However, adherence is poor either due to adverse events or lack of efficacy of therapy. There have been recent developments that include a β3-adrenoreceptor agonist and intradetrusor botulinum toxin, both of which are increasingly supported by a robust evidence base. Additionally there are emerging combination therapies and novel target agents that aim to treat this troubling syndrome. Alternative modes of delivery for existing therapies are also being explored with a view to improving adherence and efficacy. This article aims to outline the evidence base for existing and novel therapies as well as inform readers of emerging therapeutic options.