Urgency is the cornerstone symptom of overactive bladder (OAB) syndrome, which is associated with reduced health-related quality of life (HRQoL) and affects patients with different profiles. We report here three clinical pictures of OAB: a male patient with mixed lower urinary tract symptoms (LUTS), a young woman with comorbidities, and an elderly woman with mixed urinary incontinence. The aim is to analyze the specificities of these real cases, to discuss what would be the most appropriate management, and how treatment with fesoterodine, an antimuscarinic agent with key pharmacological properties, might meet the patients' expectations. Relevant and constructive messages are drawn: urgency, the cornerstone symptom, should be given special attention; fesoterodine is effective and well tolerated in the elderly; before switching to another medication consider increasing the dosage of fesoterodine; the major goal of initial therapy is to meet patient expectations; and involving the patient in the treatment plan increases her/his adherence.
Case reports in urology. 2018 Oct 16*** epublish ***
Andrea Tubaro, John Heesakkers, Jean Nicolas Cornu, Dudley Robinson
Department of Urology, Sant'Andrea Hospital, "Sapienza" University, Via di Grottarossa 1035, Rome, 00189, Italy., Department of Urology, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen 6525 GA, Netherlands., Department of Urology, Charles Nicolle University Hospital, University of Rouen, 1 rue de Germont, 76000 Rouen, France., Department of Urogynaecology, King's College Hospital, Denmark Hill, London SE5 9RS, UK.