Management of overactive bladder in women

Overactive bladder (OAB) is defined as urgency, with or without urge incontinence, usually with frequency and nocturia.

OAB has been reported in 9 to 43% of female patients. It is usually idiopathic.

The diagnosis is clinical but an initial work-up may be needed to exclude an underlying cause (bladder tumor, stone, cystitis, neurological disorder…) using urinary tract ultrasound, urine culture or cystoscopy.

The initial assessment may also include a frequency-volume chart and urodynamics. Behavioral therapy is the first line treatment. In case of failure, antimuscarinics are recommended.

Nowadays, three treatment options are available for OAB refractory to antimuscarinics: sacral neuromodulation, peripheral tibial nerve stimulation and intra-detrusor injections of botulinum toxin. Surgical procedures such as augmentation cystoplasty are very rarely required.

Prog Urol. 2015 Jul 10. pii: S1166-7087(15)00191-8. doi: 10.1016/j.purol.2015.05.014. [Epub ahead of print]

[Article in French]

Peyronnet B1, Rigole H2, Damphousse M2, Manunta A3.

1 Service d'urologie, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
2 Service de médecine physique et rééducation, CHU de Rennes, 35000 Rennes, France.
3 Service d'urologie, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35000 Rennes,