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Quick Reference Guide for Clinicians
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Diagnosis and Management of Overactive Bladder

(Published March 2011)

Using This Guide

Overactive bladder (OAB) is a common condition that adversely affects the quality of life of approximately 17 percent of adults worldwide.1,2 Characterized by lower urinary tract symptoms including urinary frequency, urgency with or without incontinence, and nocturia, OAB is believed to be due to detrusor overactivity and changes in the afferent nerve endings in the bladder.3-5 In the past, treatment for the condition was generally ineffective. For this reason and a host of patient-related and clinician-related factors, many patients suffered with OAB for years without resolution.

Fortunately, treatment is now available that can improve the symptoms of OAB. Combined with behavioral techniques, pharmacologic therapy can help patients regain control of OAB symptoms and return to more fully active lives. The initial diagnosis and treatment of OAB can be managed effectively by primary care providers, with referral to specialist care for refractory cases or when presentation or test results suggest a more complex clinical scenario. Indeed, because of the greater awareness of the availability of effective treatment, primary care providers increasingly are managing OAB treatment.

Primary care providers can play an essential role in managing OAB by identifying patients whose symptoms are consistent with the condition, promptly diagnosing and treating the disorder, and referring patients to specialists as necessary. This Quick Reference Guide for Clinicians is designed to help health care providers more easily identify and treat patients with OAB.

Considering the possibility that a woman's symptoms may represent OAB is the crucial first step in diagnosing the condition. We hope this Quick Reference Guide for Clinicians allows health care providers to confidently take the first steps in diagnosis and treatment, shortening the suffering of the many women who live with the condition.

The following abbreviations are used throughout this document:

  • BID—twice daily
  • ER—extended release
  • IR—immediate release
  • LUTS—lower urinary tract symptoms
  • OAB—overactive bladder
  • QD—once daily
  • SUI—stress urinary incontinence
  • TID—three times daily
  • UTI—urinary tract infection
  • UUI—urge urinary incontinence

References

  1. Milsom I, Abrams P, Cardozo L, et al. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int. 2001;87(9):760-6.
  2. Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20(6):327-36.
  3. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-78.
  4. Yoshida M, Masunaga K, Nagata T, et al. The forefront for novel therapeutic
    agents based on the pathophysiology of lower urinary tract dysfunction: pathophysiology and pharmacotherapy of overactive bladder. J Pharmacol Sci. 2010;112(2):128-34.
  5. Michel MC, Chapple CR. Basic mechanisms of urgency: roles and benefits of pharmacotherapy. World J Urol. 2009;27(6):705-