Nonsurgical Management of Overactive Bladder

Overactive bladder affects up to one-third of elderly adults and 17% of adult women in the United States. The diagnosis is based on patient-reported symptoms of urinary urgency and frequency, with or without urinary incontinence after exclusion of any other possible pathology. Treatment options are based on a staged approach beginning with lifestyle and behavioral modifications. Bladder training and pelvic floor muscle training have been shown to be as effective as antimuscarinic medication and possibly most useful when these therapies are combined with medication. A newer class of OAB medication, β3-adrenergic agonists, has fewer side effects compared to antimuscarinics and is an important alternative for elderly patients at a risk of dementia. This review contains 5 figures and 63 references Key Words: anticholinergic medication, antimuscarinics, β-adrenergic agonists, nocturia, overactive bladder, urge incontinence, urinary frequency, urinary urgency