[Overactive bladder-which treatment when?]

Area of Science:

• Urology
• Clinical Medicine

Background:

• Overactive bladder (OAB) is a complex of symptoms, not a specific disease.
• Effective management requires a tailored approach based on individual patient needs.

Purpose of the Study:

• To outline the diagnostic and treatment pathway for overactive bladder (OAB).
• To emphasize the importance of patient preference in selecting initial therapies.

Main Methods:

• Initial assessment relies on clinical symptoms and basic diagnostic tests.
• Treatment options include behavioral therapy, electrostimulation, and medical management.
• Further diagnostics precede minimally invasive treatments if initial therapies fail.

Main Results:

• Patient-centered care is crucial for successful OAB management.
• Behavioral therapy, electrostimulation, and medication are primary treatment modalities.
• Minimally invasive options like onabotulinumtoxin injections and sacral neuromodulation are considered after initial treatment failure.

Conclusions:

• A stepwise approach, prioritizing patient preference and less invasive methods, is recommended for OAB.
• Surgical interventions, such as augmentation cystoplasty, are reserved for rare, refractory cases.