Open Access

ARTICLE

Overactive bladder

Lesley K. Carr

Department of Surgery, Division of Urology, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Address correspondence to Dr. Lesley K. Carr, Division of Urology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Suite MG501, Toronto, Ontario M4N 3M5 Canada

Canadian Journal of Urology 2008, 15(Suppl.4), 31-36.

Abstract

Overactive bladder (OAB) is a common condition (prevalence 14%-18% of Canadians) and has a signifi cant negative impact on quality of life. OAB may be idiopathic or may occur with other common conditions such as bladder outlet obstruction, neurological disease, or stress incontinence. Primary care physicians may safely diagnose this condition by history and physical exam with a minimum of widely available lab tests. Management with behavioral therapies and pharmacotherapy is generally quite successful and warranted. Multiple anticholinergic medications are available and have been shown to be effective. Subtle differences in structure and mechanism of these agents may yield improved therapeutic benefi t or tolerability and thus it is reasonable to try more than one drug to achieve the optimal results. For patients that fail behavioral and initial pharmacotherapy or when other complicating conditions are identifi ed, referral to a specialist is indicated; however, the majority of patients with OAB do not require cystoscopy or urodynamics. Successful treatments for OAB do exist and it is worth screening for these disabling complaints at the primary care level.

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