Systematic review of overactive bladder therapy in females

Although the prevalence of overactive bladder (OAB) is similarin both male and female populations, females have a greater tendencyto seek medical advice regarding their symptoms. A reviewof the evidence of therapy among women shows that a variety ofmodalities has been shown to be effective for symptom improvementin women with OAB. Bladder retraining/re-education shouldbe considered for all women with OAB. With respect to first-linepharmacotherapy with antimuscarinic agents, the development ofextended release preparations, bladder selective M3 antagonistsand alternative routes of delivery, have improved compliance andpersistence. Other pharmacotherapeutic options with potential forproviding benefit include antidepressants, vasopressin analogues,alpha-adrenoceptor antagonists and beta-adrenoceptor agonists.There are also a number of newer agents currently being investigated,including calcium channel blocking agents, potassium channelopening drugs, beta agonists and neurokinin receptor antagonists.Intravesical injections of botulinum toxin may be an alternative,while surgery can be considered for truly intractable cases.