Overactive bladder syndrome diagnosis and treatment: literature review

Danielė Jukonienė1, Iveta Lasickaitė1

1Lithuanian University of Health Sciences, Faculty of Medicine


Overactive bladder syndrome is an extremely unpleasant disorder that is equally prevalent in men and women and manifests with symptoms such as frequent, sudden, usually painless urination, sometimes with episodes of urinary incontinence. Although urinary incontinence is more common in older people, it should not be considered normal aging.  There are several theories explaining the pathogenesis of overactive bladder syndrome, such as the myogenic, neurogenic, and autonomic bladder theory. However, the underlying mechanisms are still unclear and usually during the clinical examination of a patient no specific organic pathology is found. The main risk factors are: older age, postmenopause, childbirth, infection, neurological diseases – multiple sclerosis, brain tumors, Parkinson’s disease, stroke, dementia. Various diagnostic tests are essential to rule out other possible causes of these symptoms, such as urinary tract infection or stress urinary incontinence. Overactive bladder syndrome diagnosis can be accomplished through patient symptom resolution, urinalysis, and ultrasound, but the most objective in this case is urodynamic examination. Once overactive bladder syndrome has been diagnosed, it is important that the patient is adequately and effectively treated. Exercise that strengthens pelvic floor muscles is recommended as a first-line treatment because it is a harmless and simple method that requires no special preparation or equipment. Antimuscarinic drugs are also widely used. Their effectiveness has been proven in many scientific studies but some patients experience frustrating side effects and have to discontinue taking the medication. In such cases other, less commonly used methods should be considered, for example botulinum toxin injections into the detrusor muscle, sacral neuromodulation or transcutaneous electrical nerve stimulation. Another option is surgery. Nevertheless, nowadays surgical operations for overactive bladder syndrome are rarely performed and are only recommended when other treatment options are ineffective. In addition, preventive measures, lifestyle changes and avoidance of risk factors are equally important.

Keywords: Overactive bladder syndrome, antimuscarinic drugs.