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Chapter 1: The conditions of neurogenic detrusor overactivity and overactive bladder
Author(s) -
Haab Francois
Publication year - 2014
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22636
Subject(s) - medicine , overactive bladder , nocturia , tolerability , spinal cord injury , urinary system , anticholinergic , urology , urinary urgency , urinary incontinence , oxybutynin , refractory (planetary science) , quality of life (healthcare) , multiple sclerosis , lower urinary tract symptoms , adverse effect , spinal cord , prostate , physics , alternative medicine , nursing , pathology , cancer , psychiatry , astrobiology
Overactive bladder (OAB) is a symptom syndrome consisting of urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence (UUI), in the absence of a causative infection or pathological conditions. The prevalence of OAB is approximately 11–19% in both men and women, and leads to a significant negative effect on a patient's health‐related quality of life (HRQOL). OAB is also associated with comorbidities such as urinary tract infection (UTI) and an increased risk of falls. Following behavioral therapy, anticholinergic agents are commonly prescribed, but these often fail because of lack of efficacy and/or poor tolerability. Evaluation of treatment success in OAB should include pre‐defined, patient‐centered goals. Patients for whom oral therapy has failed to meet such goals may be considered refractory to oral therapy and candidates for minimally invasive therapy. Neurogenic detrusor overactivity (NDO) is a bladder dysfunction frequently observed in patients with conditions such as multiple sclerosis (MS) and spinal cord injury (SCI). Increased storage pressure can put the upper urinary tract at risk of deterioration and reducing this risk is a primary aim of therapy. Urinary incontinence (UI) is reported by approximately 50% of MS patients, and most SCI patients will develop some bladder dysfunction. NDO leads to a negative impact on HRQOL, independent of the impact of the primary condition. NDO patients in whom oral therapy has failed to normalize storage pressure may be considered refractory and are candidates for minimally invasive therapy. Neurourol. Urodynam. 33:S2–S5, 2014 . © 2014 Wiley Periodicals, Inc.