Behavioral Versus Drug Treatment for Overactive Bladder in Men: The Male Overactive Bladder Treatment in Veterans (MOTIVE) Trial

Burgio, Kathryn L.; Goode, Patricia S.; Johnson, Theodore M.; Hammontree, Lee N.; Ouslander, Joseph G.; Markland, Alayne D.; Colli, Janet; Vaughan, Camille P.; Redden, David T.

doi:10.1111/j.1532-5415.2011.03724.x

Cited by 87 publications

(77 citation statements)

References 38 publications

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“…The literature provides clear support for the effectiveness of both bladder and behavioral training. 11,12 The literature supports the positive effects of weight loss on incontinence specifically. A relatively minor weight loss of 8% in obese woman reduced overall incontinence episodes per week and urgency urinary incontinence episodes by 47 and 42% vs. 28 and 26% in controls.…”

Section: Grade B)mentioning

confidence: 88%

Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline

et al. 2012

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Section: Grade B)mentioning

confidence: 88%

Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline

et al. 2012

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“…Burgio et al conducted a randomized controlled trial (RCT) of 143 men with bladder outlet obstruction (BOO) and OAB who had failed alpha-blocker therapy. 10 Patients were assigned to 8 weeks of behavioral therapy or oxybutynin. Behavioral therapy reduced nocturia by 0.7 voids per night, as compared with 0.32 voids per night for oxybutynin (P ¼ .05; LOE 3).…”

Section: Conservative Managementmentioning

confidence: 99%

Nocturia: Current Levels of Evidence and Recommendations From the International Consultation on Male Lower Urinary Tract Symptoms

Marshall

Raskolnikov

Blanker

et al. 2015

Urology

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“…Equivalence analysis was performed and indicated that posttreatment means were equivalent. There was a significantly greater reduction in nocturia and maximum urgency scores in the behavioral therapy and anticholinergic group, respectively [33].…”

Section: Behavioral Therapymentioning

confidence: 87%

Medical Therapy in Overactive Bladder of the Elderly

Bayrak

Mock

Dmochowski

2014

Curr Bladder Dysfunct Rep

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The number of patients exhibiting overactive bladder (OAB) symptoms and its associated medical, social, and economic problems will increase with the growing elderly population. The basic therapeutic approach in all elderly people should include the exploration of correctable factors to build a corrective approach for OAB. Lifestyle modifications and behavioral therapies should be attempted initially, but if the patients are persistently bothered by their symptoms with no benefit from initial therapy, pharmacological agents can be added to conservative therapies. Anticholinergics are the most studied and prescribed agents. In the end, treatment of OAB in the elderly requires a careful and holistic evaluation before deciding on the most appropriate management as a number of concomitant factors that can cause OAB symptoms in this age range."urgency, with or without urge incontinence, usually with increased frequency and nocturia." [1]. It is estimated to affect approximately one third of individuals over 65 years old [2,3]. Additionally, current population forecasts estimate a global increase in the proportion of people aged over 65 years, with the greatest rise being in those aged over 80 [4]. It would be reasonable to expect patients exhibiting OAB symptoms, and the subsequent medical, social, and economic burden associated with these patients to increase as well. In a large Japanese study, Homma et al. reported that OAB compromised healthrelated quality of life (QoL) in more than half (53 %) of respondents and affected emotions (42 %), sleep/vitality (37 %), and physical capability (34 %) [5]. The detrimental effects on the individual is closely related to the occurrence of urgency and urge urinary incontinence (UUI), which can make it difficult for them to maintain regular daily activities due to the need to be in close proximity to toilet and the possible embarrassment of urine loss [6••]. More concerning, OAB and especially nocturia has been linked to the rise in the risk of falls, fractures, and even death [3,[7][8][9]. Pathophysiology of Overactive Bladder in the ElderlyNormal bladder function involves a complex coordination of the urinary tract and nervous system. When the bladder fills, it functions as a compliant structure which is capable of relaxation and with pressure that remains lower than the urethral resistance. During normal micturition, a decrease in urethral resistance and tonic contraction of the detrusor smooth muscle occurs. OAB symptoms, on the other hand, are frequently caused by involuntary contraction due to detrusor overactivity (DO), either occurring idiopathically or after neurological insult. A distinction is generally made to distinguish DO from either of these causes, but in the elderly, it is often unclear as it can be a result of normal aging or a prior/ongoing neurological event which is sometimes clinical unapparent. By comparison,

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Behavioral Versus Drug Treatment for Overactive Bladder in Men: The Male Overactive Bladder Treatment in Veterans (MOTIVE) Trial

Abstract: Behavioral and antimuscarinic therapy are effective when added to alpha-blocker therapy for OAB in men without outlet obstruction. Behavioral treatment is at least as effective as antimuscarinic therapy.

Cited by 87 publications

References 38 publications

Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline

Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline

Nocturia: Current Levels of Evidence and Recommendations From the International Consultation on Male Lower Urinary Tract Symptoms

Medical Therapy in Overactive Bladder of the Elderly

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