Urol. praxi. 2023;24(4):211-216 | DOI: 10.36290/uro.2023.081

Treatment of a patient with refractory overactive bladder

MUDr. Marie Pechová, MUDr. Jan Mečl
Urologické oddělení, Krajská nemocnice Liberec, a. s.

The term overactive bladder (OAB) expresses a set of symptoms where urgency is an obligatory symptom. On the basis, other symptoms develop, including increased urinary frequency, nocturia and incontinence may also be present (occurs in approximately 1/3 of patients). We divide patients into two groups, weather they are incontinent or not. Treatment of OAB is initiated with behavioural therapy, which is eventually followed by pharmacological treatment. If both methods fail, we are talking about refractory OAB, where more invasive treatment methods are needed. According to the 2006 EPIC study, the prevalence of OAB in the population is 11.8% (1). In general, the incidence of this condition increases with aging, while under the age of 60 this disease is more common in women, after the 7th decade it prevails in men (2). Due to increasing life expectancy, an increase in prevalence can be expected. Although it is not a life-threatening disease, this syndrome has a high impact on the quality of life of patients. It affects not only physical health but especially psychological health. Unfortunately, the disease is overlooked by many sufferers, who believe that there is no help, consider it part of ageing or are ashamed of their problems. Alarmingly, 40-70% of patients never confide their problems to a doctor (3).

Keywords: overactive bladder, refractory, treatment.

Accepted: November 27, 2023; Published: November 30, 2023  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Pechová M, Mečl J. Treatment of a patient with refractory overactive bladder. Urol. praxi. 2023;24(4):211-216. doi: 10.36290/uro.2023.081.
Download citation

References

  1. Irwin DE, Milsom I,k Hunskaar S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries, reswults of the EPIC study. Eur Urol. 2006;50(6):1306-1314. Go to original source... Go to PubMed...
  2. https://www.cus.cz/pro-pacienty/diagnozy/oab-syndrom-syndrom-hyperaktivniho-mocoveho-mechyre/.
  3. Kinchen KS, Burgio K, Diokno AC, et al. Factors associated with women´s decisions to seek treatment for urinary incontinence. J Womens Healts (Larchmt). 2003:12(7):687-698. Go to original source... Go to PubMed...
  4. Krhut J. Hyperaktivní močový měchýř, 2. rozšířené a přepracované vydání. Praha: Maxdorf; 2011.
  5. Hanuš T Farmakologické ovlivnění dynamiky dolních močových cest. Rozhl Chir. 1982:61(1):42-46.
  6. de Groat WC. Anatomy of the central neural pathways controlling the lower urinary tract. Eur Urol. 1998:34(Suppl 1):2-5. Go to original source... Go to PubMed...
  7. Blok B, Castro-Diaz D, Del Popolo G, et al. Sartori Guidelines Office: Schouten N, Smith EJ. EAU Guidelines on Neuro - Urology. 2023;9.
  8. Moore KH, Simons A, Mukerjee C, et al. The relative incidence of detrusor instability and bacterial cystitis detected on the urodynamic - test day. BJU Int. 2000:85:786-792. Go to original source... Go to PubMed...
  9. Andersson KE, Chapple CR, Cardozo L, et al. Pharmacological treatment of overactive bladder report from the International Consultation on Incontinence. Curr Opin Urol. 2009:19:380-394. Go to original source... Go to PubMed...
  10. Krofta L, Feyereisl J. Hormonální substituce v léčbě inkontinence moči u žen. Urol. praxi. 2002;4:166-166. Available from: https://www.urologiepropraxi.cz/pdfs/uro/2002/04/06.pdf.
  11. Stoller ML. Afferent nerve stimulation for pelvic floor dysfunction. Eur Urol. 2000:37(Suppl.2):33.
  12. Schultz-Lampel D, Jiang C, Lindstrom S, et al. Experimental results on mechanisms of action of electrical neuromodulation in chronic urinary retention. World J Urol. 1998:16(5):301-304. Go to original source... Go to PubMed...
  13. https://www.tribune.cz/archiv/vyzkum-ceskych-vedcu-zlepsuje-lecbu-inkontinence/.
  14. Schurch B, Stohrer M, Kramer G. Botulinum - A-toxin for treating detrusor hyperreflexia in spinal cord injured patients: a new alternative to anticholinergic drugs? Preliminary results. J Urol 2000:164:692-697. Go to original source... Go to PubMed...
  15. Schmid DM, Sauermann P, Werner M, et al. Experience with 100 cases treated with botulinum-A toxin injection in the detrusor muscle for idiopatic overactive bladder syndrome refractory to anticholinergics. J Urol 2006:176:177-185. Go to original source... Go to PubMed...
  16. Čermák A. Možnosti chirurgické léčby hyperaktivního močového měchýře (OAB), Urol List. 2008:6(1):35-43.
  17. Mundy AR, Stephenson TP. "Clam" ileocystoplasty for the treatment of refractory urge incontinence. Br J Urol. 1985:641-646. Go to original source... Go to PubMed...
  18. Holm J, Struckmann JR, Frimoldt-Moller C. Augmentation ileo-cystoplasty in woman with disabling urge inconctinence. Ugeskr Laeger. 1995:157:1528-1530.




Urology for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.