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Detrusor Underactivity Model in Rats by Conus Medullaris Transection

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Current optimal pharmacologic therapies for overactive bladder.

Yuan-Hong Jiang¹, Hann-Chorng Kuo¹

¹Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.

Expert Opinion on Pharmacotherapy

|September 26, 2023

Summary

This summary is machine-generated.

Overactive bladder (OAB) treatments include oral medications and botulinum toxin A injections. Tailoring therapy to OAB pathophysiology improves outcomes for patients with refractory symptoms.

Keywords:

Urinary incontinence bladder medical treatment pathophysiology pharmacotherapy

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Area of Science:

Urology
Pharmacology

Background:

Overactive bladder (OAB) is a prevalent condition in adults.
Current treatments include antimuscarinic agents and beta-3 adrenoceptor agonists.
Botulinum toxin A (BoNT-A) injections offer an option for non-responders.

Purpose of the Study:

Review recent clinical trial results for OAB.
Discuss the underlying pathophysiology of OAB.
Present appropriate medical therapies based on OAB pathophysiology.

Main Methods:

Literature search of PubMed from 2001 to 2023.
Inclusion of clinical background, pharmacology, and clinical studies for OAB medications.

Main Results:

Antimuscarinics and beta-3 agonists are feasible first-line OAB treatments.
Combination therapy can enhance efficacy for suboptimal responses.
Intravesical BoNT-A injections are effective for refractory OAB.

Conclusions:

Investigate OAB pathophysiology for refractory cases.
Consider adding alpha-1 blockers or anti-inflammatory agents.
Behavioral modification and patient education are crucial adjuncts to pharmacotherapy.