SEARCH · PubMed Health

Results for “overactive bladder”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources

PubMed2003

Percutaneous tibial nerve stimulation in the treatment of overactive bladder: urodynamic data.

AIM: The aim of this study was to evaluate urodynamic changes after percutaneous tibial nerve stimulation (PTNS) for the treatment of complaints related to overactive bladder syndrome and to search for urodynamic-based predictive factors. METHODS: Ninety consecutive patients with symptoms related to overactive bladder syndrome were enrolled in this study. Patients underwent 12 PTNS sessions. For evaluating objective success, the primary outcome measure was a reduction in number of urinary leakage episodes of 50% or more per 24 hours. Patients' request for continuation of therapy was considered subjective success. This study focussed on urodynamic features at baseline and on changes found after 12 PTNS treatments. RESULTS: The objective success rate was 56% (leakages/24 hours). Subjective success rate was 64%. Frequency/volume chart data and quality of life scores improved significantly (P < 0.01). Pre- and posturodynamic data were available from 46 participants. Detrusor instabilities (DI) could be abolished in a few cases only. Increments in cystometric bladder capacity and in volume at DI were significant (P = 0.043 and 0.012, respectively). Subjects without detrusor instabilities at baseline were 1.7 times more prone to respond to PTNS (odds ratio, 1.75; 95% confidence interval [CI], 0.67-4.6). The more the bladder overactivity was pronounced, the less these patients were found to respond to PTNS, the area under the receiver operating curve was 0.644 (95% CI, 0.48-0.804). CONCLUSION: PTNS could not abolish DI. PTNS increased cystometric capacity and delayed the onset of DI. Cystometry seemed useful to select good candidates: patients without DI or with late DI onset proved to be the best candidates for PTNS.

Adult↗

PubMed1997

Management of overactive bladder--looking to the future.

OBJECTIVES: To offer a perspective on potential future advances in the understanding and management of the overactive bladder. METHODS: Consideration is given to potential developments in the areas of pathophysiology, prevention, early intervention, and new pharmacologic targets for the treatment of overactive bladder. RESULTS: The future will likely reveal that motor urgency is usually a premature micturition reflex with a limited and variable degree of penetrance. Overactivity of all types in the lower urinary tract (LUT) will be regarded as the result of a partially uncontrolled on-off mechanism in the nervous system. Neurogenic factors will be found to initiate a premature activation of urethral and bladder activity, whereas myogenic factors will be recognized as serving as facilitators. As is the case today, we will probably be unable to cure or normalize the overactive bladder in the future. However, our growing understanding of the pathophysiology of the LUT will open up new possibilities for prophylactic, diagnostic, and therapeutic measures. Advances in cellular and molecular biology may allow early intervention or even prevention of the overactive bladder. Pharmacologic treatment will not only aim at functional intervention, but will attempt to influence the structure of the organs by means of trophically active drugs. Prevention of muscle cell hypertrophy and induction of nerve growth might become therapeutic realities. CONCLUSIONS: The future holds the promise of important advances that will improve our understanding of the overactive bladder and will hopefully lead to more effective treatments.

Adrenergic Antagonists↗

PubMed2001

Prospective randomized controlled trial of extended-release oxybutynin chloride and tolterodine tartrate in the treatment of overactive bladder: results of the OBJECT Study.

OBJECTIVE: To compare the efficacy and tolerability of extended-release oxybutynin chloride and tolterodine tartrate at 12 weeks in participants with overactive bladder. SUBJECTS AND METHODS: The OBJECT (Overactive Bladder: Judging Effective Control and Treatment) study was a prospective, randomized, double-blind, parallel-group study conducted between March and October 2000 at 37 US study sites. Participants who had between 7 and 50 episodes of urge incontinence per week and 10 or more voids in 24 hours received extended-release oxybutynin, 10 mg/d, or tolterodine, 2 mg twice daily. The outcome measures were the number of episodes of urge incontinence, total incontinence, and micturition frequency at 12 weeks adjusted for baseline. RESULTS: A total of 315 women and 63 men were randomized and treated, and 332 participants (276 women, 56 men) completed the study. At the end of the study, extended-release oxybutynin was significantly more effective than tolterodine in each of the main outcome measures: weekly urge incontinence (P=.03), total incontinence (P=.02), and micturition frequency episodes (P=.02) adjusted for baseline. Both drugs improved symptoms of overactive bladder significantly from baseline to the end of the study as assessed by the 3 main outcome measures (P<.001). Dry mouth, the most common adverse event, was reported by 28.1% and 33.2% of participants taking extended-release oxybutynin and tolterodine, respectively (P=.32). Rates of central nervous system and other adverse events were low and similar in both groups. CONCLUSIONS: Extended-release oxybutynin was more effective than tolterodine as measured by end-of-study urge incontinence, total incontinence, and micturition frequency episodes. Both groups had similar rates of dry mouth and other adverse events.

Aged↗

PubMed2004

A review of quality-of-life questionnaires for urinary incontinence and overactive bladder: which ones to use and why?

Overactive bladder (OAB) and stress urinary incontinence have a profound impact on patients' health-related quality of life (HRQL). The purpose of this article is to identify and describe condition-specific HRQL measures validated among patients with symptoms of OAB or stress urinary incontinence. A Medline literature search was performed to identify published articles or abstracts focusing on the development and psychometric validation of relevant instruments. Target populations and psychometric properties (reliability, validity, responsiveness to change) of 16 questionnaires are reviewed. A range of well-validated, condition-specific HRQL measures are available. Recommendations are provided regarding which measures to use in different situations. When choosing among instruments, psychometric evidence and the match of an instrument to the study population should be considered.

Female↗

PubMed2005

Antimuscarinic agents: implications and concerns in the management of overactive bladder in the elderly.

BACKGROUND: Overactive bladder (OAB) is a widespread problem that has a negative effect on quality of life, particularly among the elderly. Antimuscarinic agents are the only drug class with broad, accepted efficacy in the treatment of OAB. Their clinical usefulness, however, is limited by dose-dependent adverse effects. In the elderly, the most serious of these is central nervous system (CNS) dysfunction, including cognitive impairment. OBJECTIVE: This article examines currently available antimuscarinic agents for the treatment of OAB in terms of their likelihood of causing CNS dysfunction by crossing the blood-brain barrier (BBB) and blocking muscarinic type 1 (Ml) receptor sites in the brain. METHODS: Pertinent studies were selected from a comprehensive review of the OAB literature with a focus on muscarinic receptor-associated mechanisms leading to CNS adverse effects and their potential impact on elderly patients. MEDLINE was searched for articles published in the past 10 years, and additional articles were obtained from the reference lists of identified publications. Also searched were abstracts of recent meetings of the International Consultation on Incontinence, International Continence Society, American Urological Association, and European Association of Urology. RESULTS: Antimuscarinic agents control involuntary detrusor muscle contractions through cholinergic blockade at the muscarinic receptors. The prevalence of OAB is highest in the elderly, the population most likely to be taking multiple anticholinergic medications and most vulnerable to the CNS adverse effects of these agents. Nonselective antimuscarinic agents that bind to the Ml receptor are most likely to cause significant cognitive adverse effects compared with the more selective antimuscarinic agents for the treatment of OAB. CONCLUSIONS: When considering use of an antimuscarinic agent for the treatment of OAB in elderly patients, prescribers should routinely consider the agent's receptor selectivity and ability to cross the BBB. The medical history should include all current medications that may contribute to the anticholinergic burden and cognitive impairment. Patients and caregivers should be educated to recognize anticholinergic adverse effects.

Aged↗

PubMed2002

Medical therapy for the overactive bladder in the elderly.

The overactive bladder is the commonest underlying bladder disorder causing urinary incontinence in elderly people. Management of the condition relies upon a holistic assessment of the problem, lifestyle adjustment, behavioural management and drug therapy. The majority of currently available drugs rely on their anti-muscarinic properties for efficacy. Both behavioural techniques and drug therapy are effective in treatment of the elderly and each modality has a particular role to play in successful treatment and maintenance of this condition.

Aged↗

PubMed2005

Antimuscarinic management of overactive bladder.

The symptoms of an overactive bladder (OAB) has a negative effect on the health-related quality of life of a sufferer. Many do not seek help and up to 73% of those of who are assessed do not take medication to relieve their symptoms. The key to managing this condition is a multidisciplinary approach to conservative behaviour therapy in the form of bladder training. This management is more effective when combined with antimuscarinic medication.

Female↗

PubMedDate not supplied

The overactive bladder.

The problem of an overactive bladder is common and can have a major impact on patients' lives. This article describes the possible causes of the condition and the interventions available to help to control it.

Drinking↗

PubMed2001

Overactive bladder: optimizing quality of care.

Overactive bladder (OAB), the symptom complex of urinary urgency and frequency with or without urge incontinence, affects the lives of millions of Americans. In recent years, more successful treatment options have emerged as advances have been made in understanding the pathophysiologic processes underlying OAB symptoms. However, because most therapeutic modalities for OAB are aimed at symptom resolution, rather than the treatment of distinct pathologic entities, a basic evaluation is required for all patients to establish whether existing (and treatable) pathologic processes are present. In the absence of these processes, symptom relief is both the objective and the outcome used to judge the efficacy of a specific modality. The type of therapy recommended for OAB may depend on several factors including age, existing behavioral patterns, estrogen status, degree of motivation, environmental surroundings, presence of other coexisting urinary symptoms, family support, and patient expectations. This article focuses on methods of identifying patients with OAB, and the role of developing strategies in treating this common disorder.

Aged↗

PubMedDate not supplied

The overactive bladder and quality of life.

Overactive bladder (OAB) affects 16.6% of the U.S. population, or 33 million adults, in some form. Despite the prevalence of OAB, almost 60% of those affected seek no medical assistance for the condition either because of embarrassment or the misconception that it represents an inevitable function of aging. A recent surge of interest on the subject has uncovered the dramatic effect that OAB can have on social interactions, sleep, depression, sexual health, and overall health-related quality of life (HRQoL). The introduction of validated, condition-specific QOL questionnaires has enhanced our ability to measure these subjective dimensions of OAB, and to assess their response to therapeutic interventions.

Adaptation, Psychological↗

PubMed2001

Tolterodine reduces the number of urge incontinence episodes in patients with an overactive bladder.

OBJECTIVE: To evaluate the efficacy, safety and tolerability of tolterodine compared to placebo in patients with an overactive bladder. STUDY DESIGN: A double-blind, multi-centre phase III study in France and Belgium 251 patients with overactive bladder symptoms, and urodynamically verified detrusor overactivity, were randomised to receive 4-week treatment with either placebo or tolterodine 1 or 2mg twice daily (bd). Efficacy was evaluated from patient micturition diaries. Safety and tolerability endpoints were also evaluated. RESULTS: After 4-week treatment, the number of incontinence episodes/24h decreased significantly relative to placebo in the tolterodine 1 and 2 mgbd groups (P=0.045 and P=0.0089, respectively). Both dosages of tolterodine increased volume voided per micturition compared with placebo (P=0.055 and P=0.056, respectively), although significant decreases in micturition frequency were not apparent. Tolterodine was safe and well tolerated, few patients were withdrawn due to adverse events. Dry mouth, mainly of mild-to-moderate intensity, was the most common adverse event. No clinically relevant changes in blood pressure or laboratory safety variables were reported. CONCLUSION: Tolterodine is effective, safe and well tolerated for the treatment of symptoms of an overactive bladder, particularly urge incontinence.

Adolescent↗

PubMed2006

Overactive bladder: prevalence and implications in Brazil.

OBJECTIVES: To assess overactive bladder (OAB) prevalence, associated factors and implications in a young population. METHODS: An independent population-based study was carried out. A self-applicative questionnaire covering urinary symptoms, coping strategies, quality of life and treatment seeking behavior was developed. RESULTS: A total of 848 subjects between 15 and 55 years completed the questionnaire. The overall prevalence of OAB was 18.9%. Women were significantly more affected than men (p = 0.001). All age groups were equally affected (p = 0.152). Subjects with OAB reported significant impairment on household chores (p = 0.009), physical activities (p = 0.016), sleep (p < 0.001), work (p < 0.001), social life (p < 0.001) and sexual life (p < 0.001). In addition, OAB individuals present higher prevalence of depression (p = 0.036), anxiety (p < 0.001), shame (p < 0.001) and tiredness (p < 0.001) OAB was independently associated to sexual life impairment (OR = 3.36, 95% CI=1.20-9.39). Only 27.5% of OAB subjects sought for medical counseling. CONCLUSIONS: OAB is a highly prevalent condition, even in such a young population. It affects both genders, yet it is more frequently observed in women. OAB is an important health condition, with serious impact on quality of life and sexual function. A large percentual of individuals remain unrecognized, under treated and consequently suffer for long periods of time.

Adult↗

PubMed2006

Sacral nerve stimulation for the overactive bladder.

Pharmacotherapy is the first-line treatment for overactive bladder, but many patients discontinue drug therapy because of intolerable side effects, expense, or lack of longterm adherence. Alternative treatments are needed for patients who are unable to tolerate pharmacotherapy or who do not derive the desired benefits. Sacral nerve stimulation therapy has evolved into one of the most widely accepted treatment modalities in the arena of neurourology. Sacral nerve stimulation activates or "resets" the somatic afferent inputs that play a pivotal role in the modulation of sensory processing for micturition reflex pathways in the spinal cord. This minimally invasive technology offers a safe, reliable, and durable treatment for lower urinary tract dysfunction.

Electric Stimulation Therapy↗

PubMedDate not supplied

Outcome of overactive bladder in children.

One hundred forty-four children with a clinical diagnosis of overactive bladder were observed for a mean of 3.15 +/- 1.92 years. Initial management consisted of a behavioral modification program that included increased fluid intake, a timed voiding schedule and, if applicable, treatment of constipation. Those who failed to improve with the preceding intervention within 10 days to 2 weeks received an anticholinergic medication. Follow-up information was obtained by telephone. Caretakers and/or patients were asked a standard set of questions. The outcome with respect to urinary urgency, urinary frequency, daytime incontinence, posturing and urinary tract infections was recorded. After an average follow-up period of 3 years, 68 (47.2%) of the 144 children recovered from all symptoms of overactive bladder and 61 (42.4%) had decreased symptoms. Fifteen of the children, or 10.4%, still had all of the symptoms originally associated with overactive bladder. Children who had posturing as one of their symptoms had a significantly increased risk of urinary tract infection.

Behavior Therapy↗

PubMed2006

Tolterodine for treatment of overactive bladder.

Tolterodine was developed as an antimuscarinic agent specifically for the treatment of overactive bladder. Initial in vivo studies demonstrated a functional selectivity for the muscarinic receptors in the urinary bladder over the salivary glands, and subsequent clinical trials showed an overall superior tolerability profile compared with other drugs in the same class (ie, oxybutynin). With immediate- and extended-release formulations and sustained clinical efficacy during long-term treatment, tolterodine gas become an important treatment option for the symptoms of overactive bladder.

Benzhydryl Compounds↗

PubMed2003

Prevalence and correlation of urinary incontinence and overactive bladder in Taiwanese women.

AIMS: We randomly sampled a community-based, healthy population to evaluate the prevalence and correlation of urinary incontinence and overactive bladder. We also assessed the influences of these conditions on quality of life and associated risk factors. METHODS: Of the 1,581 women sampled (2.92% of registered female residents aged 20 years and older), 1,253 (79.1%) women were successfully interviewed by using the Bristol Female Urinary Tract Symptoms Questionnaire (r=0.87, P<0.05) and the Questionnaire of Impact index regarding the impact on quality of life (r=0.91, P<0.05). RESULTS: A total of 53.7% of the women sampled suffered from urinary incontinence and related symptoms. The prevalence of stress urinary incontinence, overactive bladder, and mixed incontinence, mutually exclusive of each, was 18.0%, 18.6%, and 17.1%, respectively, from the patients' perceptions. Judging by the criteria of the International Continence Society, the prevalence of the above three conditions was 4.3%, 2.4%, and 1.8%, respectively. Of the women who perceived storage symptoms, 21.1% experienced frequency, 12.6% had urgency, 25.5% had nocturia, and 9.1% had urge incontinence. The occurrence of stress urinary incontinence increased with age up to 65 years old (25% in 50-65-year-old cohort), and the number of overactive bladder conditions significantly increased in the elderly women (over 65 years old, 39.3%). Approximately two thirds of the incontinent women had restricted their social activities (due to worrying about wetting or leakage and no toilet facilities available), and approximately 19% of the incontinent women had an affected sexual life. However, only 27.1% of the women with urinary incontinence and related symptoms in this study had reported seeking medical services to solve these problems. CONCLUSIONS: The prevalence of urinary incontinence and overactive bladder in Taiwanese women is similar to that of Western women.

Adult↗

PubMed2006

Symptom bother and health-related quality of life outcomes following solifenacin treatment for overactive bladder: the VESIcare Open-Label Trial (VOLT).

BACKGROUND: Most clinical trials designed to evaluate overactive bladder (OAB) syndrome treatments have focused on measuring micturition variables from bladder diaries. However, although diaries help physicians assess symptoms objectively, they lack information on patients' subjective experience of OAB symptoms and the effects of treatment. OBJECTIVE: The objective of this study was to assess patients' perceptions of improvements in symptom bother and health-related quality of life (HRQOL) with solifenacin succinate 5- and 10-mg treatments in patients with OAB. METHODS: VOLT (VESIcare Open-Label Trial) was a prospective, flexible-dosing trial performed at 207 centers in the United States. Ambulatory adult (aged > or = 18 years) men and women with an established diagnosis of OAB (urgency, urge urinary incontinence, frequency, and/or nocturia for > or = 3 months) and who provided a sterile urine sample received solifenacin QD for 12 weeks. Initially, all patients received 5 mg/d, with the option of adjustment to 10 mg/d at 4 and 8 weeks. Effectiveness was assessed using the Patient Perception of Bladder Condition (PPBC) scale, a visual analog scale (VAS) for the degree of bother caused by individual OAB symptoms, and the overactive bladder questionnaire (OAB-q). Assessments were performed at study initiation and study end or study termination. Adverse events (AEs) were assessed throughout. RESULTS: Patients (N = 2225) were enrolled between June 2004 and April 2005. Patients with baseline data (n = 2205) had a mean (SD) age of 59.7 (14.4) years; most patients were women (1813 [82.2%]) and white (1761 [79.9%]). Of the total patients enrolled, 1743 (78.3%) completed all 12 weeks of the study. After 12 weeks of solifenacin treatment, improvement was observed in the mean values of patient-reported perception of bladder condition. Significant change was observed on the PPBC scale from the mean baseline value to study end (4.4 vs 2.9; P < 0.001). All subscales of HRQOL significantly improved on the OAB-q score (mean changes, 14.7 to 29.6; all, P < 0.001). On the VAS, there was a significant reduction in the degree of bother associated with urgency, urge urinary incontinence, frequency, and/or nocturia (mean changes in VAS ratings, -36.7 to -41.8; all, P < 0.001 vs baseline). Solifenacin was well tolerated in most patients. Treatment-emergent AEs were reported by 1321 (59.4%) patients. Most reported AEs were anticholinergic in nature and of mild to moderate severity: dry mouth, 477 (21.4%); constipation, 295 (13.3%); headache, 76 (3.4%); blurred vision, 57 (2.6%); nausea, 39 (1.8%); dyspepsia, 34 (1.5%); and dry eye, 29 (1.3%). Two hundred sixteen (9.7%) patients discontinued treatment due to AEs. CONCLUSION: Flexibly dosed solifenacin 5 and 10 mg QD was associated with reductions in patient-reported OAB symptom bother and improvements in patients' perception of bladder condition and HRQOL.

Adolescent↗

PubMed2003

Measurement characteristics of a voiding diary for use by men and women with overactive bladder.

OBJECTIVES: To examine the test-retest reliability and the validity of a voiding diary designed to assess the symptoms of frequency, urgency, and urge urinary incontinence (UI). METHODS: Voiding diaries serve as the primary tool to assess symptoms of overactive bladder in clinical settings and in clinical trials of treatment for overactive bladder. Despite the widespread use of these instruments, few studies have documented their measurement properties or investigated the number of days required to assess symptoms accurately. Study participants included 21 men and 133 women at least 20 years of age recruited from urogynecology and urology clinics. All had a history of urge incontinence or mixed incontinence with urge as the primary component. Participants completed a 7-day voiding diary on two occasions, separated by at least 1 week. RESULTS: Men and women reported a daily average of approximately 10 micturitions, 7 occurrences of strong urge, and 2 episodes of urge urinary incontinence. The diary exhibited good to excellent reliability, with estimated intraclass correlation coefficients (ICCs) ranging from 0.81 to 0.86 for the symptoms of strong urge, diurnal and nocturnal micturitions, total incontinence, and urge incontinence episodes. Estimates did not differ appreciably between men and women. Moderate correlations with global questions on micturition frequency and UI episodes supported the validity of the diary. Diaries completed for 3 and 4 days were similar, with only slightly lower estimates of reliability (ICC 0.79 to 0.84). CONCLUSIONS: The voiding diary completed for 7 days, following detailed instruction, is reliable and appears to be valid for documenting the change in symptoms of overactive bladder in men and women with predominantly urge incontinence. Because of comparable reliability and reduced patient burden, diaries of shorter duration may also be acceptable to assess the symptoms of overactive bladder, depending on the degree of precision required.

Aged↗