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OVERACTIVE BLADDER IN CHILDREN AND ADULT PATIENTS


Authors: R. Sobotka;  T. Hanuš;  K. Novák
Authors‘ workplace: Urologická klinika 1. LF UK a VFN, Praha
Published in: Urol List 2010; 8(3): 83-88

Overview

Overactive bladder (OAB) is a symptom-based syndrome characterized by the presence of urgency or urgent incontinence. It is defined as a sudden and compelling desire to void that cannot be postponed. OAB may have significant impact on the quality of life. The overall prevalence of OAB symptoms is about 16 %. OAB may be idiopathic or may occur with other conditions such as bladder outlet obstruction, neurological condition, metabolic disease, urinary tract infection, bladder cancer or stress incontinence. It is suggested that obesity, smoking, consumption of carbonated drinks and caffeine intake are risk factors for OAB. OAB is chronic condition that requires long-term management. Many treatment options exist for OAB, including behavioral therapies such as pelvic floor muscle rehabilitation, bladder training, and dietary mo­di­fication, as well as traditional therapies such as pharmacological therapy and neuromo-dulation. For patients that fail behavioral and initial pharmacotherapy or when other complicating conditions are identified, specialized examination is indicated; however, the majority of patients with OAB do not require cystoscopy or urodynamics. Multiple anticholinergic medications are available and have been shown to be effective. All anticholinergics have the same effect, but they have a different spectrum of side effects, which are given by preferential blockade of antimuskarin receptors, penetration through the hematoencephallic barrier and first-pass liver metabolism. The main problem in the pe­diatric urology is the lack of randomized trials in pediatric patients, which would bring more selective drugs on the market.

Key words:
overactive bladder, OAB, urgency, urinary frequency, urgent incontinence, nocturia, behavioral therapy, pelvic floor muscle therapy (PFMT), pelvic floor muscle contractions, detrusor overactivity, idiopathic OAB, antimuscarinics


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