Overactive Bladder: A Better Understanding of Pathophysiology, Diagnosis and Management

Wein, Alan J.; Rackley, Raymond R.

doi:10.1016/s0022-5347(05)00313-7

Cited by 158 publications

(137 citation statements)

References 24 publications

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“…It remains unknown whether treatment of medical and psychological illnesses can result in meaningful improvement in urologic symptoms, or conversely, whether several urologic symptoms can provide valuable insight into an individual's overall health status. We may need to revise current evaluation and treatment approaches for urologic symptoms [52] that tend to be focused on the urinary tract, with relatively little attention to the contributions that co-morbid illnesses may make to symptoms.…”

Section: Resultsmentioning

confidence: 99%

Beyond the Lower Urinary Tract: The Association of Urologic and Sexual Symptoms with Common Illnesses

et al. 2007

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Objective-In addition to being prevalent and bothersome, urologic and sexual symptoms may be related to chronic medical illnesses. We investigate the relationship between ten urologic and sexual symptoms and four major illnesses (type II diabetes, cardiac disease, hypertension, and depression).Methods-We analyze data from the Boston Area Community Health (BACH) Survey, a community-based epidemiologic study of urologic symptoms and risk factors. BACH used a twostage stratified cluster sampling design to recruit 5,506 adults aged 30-79 (2,301 men, 3,205 women; 1,770 Black, 1,877 Hispanic, and 1,859 White respondents).Results-In bivariate analyses, most urologic and sexual symptoms are associated with type II diabetes, cardiac disease, hypertension, and depression. However, in multivariate models adjusting for all four illnesses, gender, race/ethnicity, age, alcohol intake, smoking, physical activity, and body mass index there were fewer significant associations. We found that all urologic symptoms were significantly related to at least one illness, with depression increasing the odds of all urologic and sexual symptoms studied.Conclusions-Urinary tract specialists may need to give greater weight to consideration of factors outside the urinary tract that may be contributing to urologic symptoms. It remains unknown whether treatment of medical and psychological illnesses can result in meaningful improvement in urologic symptoms, or conversely, whether urinary tract symptoms can provide valuable insight into an individual's overall health status. Keywords epidemiology; diabetes; hypertension; cardiac disease; depression; lower urinary tract symptoms; painful bladder syndrome; urinary incontinence; prostatitis; overactive bladder; frequency; urgency; nocturia; erectile dysfunction; female sexual dysfunction Corresponding author: Dr. Carol L. Link, New England Research Institutes, 9 Galen Street, Watertown, MA 02472, USA, Telephone: (1) 617-923-7747, Fax: (1) 617-926-8246, clink@neriscience.com. Take-home message Urological and sexual symptoms are significantly associated with depression, and to a lesser extent with cardiac disease, type II diabetes, and hypertension. Providers may need to look beyond the bladder and lower urinary tract to understand and/or treat presenting symptoms.

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Section: Resultsmentioning

confidence: 99%

Beyond the Lower Urinary Tract: The Association of Urologic and Sexual Symptoms with Common Illnesses

et al. 2007

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“…3 UUI, in turn, is present in one third of the patients. 4 Enuresis, nocturia and urinary leakage due to stress incontinence are also reported. 5 The main therapeutic modalities are conservative therapies, such as pharmacological treatment and behavioral therapy.…”

Section: Introductionmentioning

confidence: 99%

Pelvic floor muscle training for overactive bladder symptoms – A prospective study

Fitz

Sartori

Girão

et al. 2017

Rev. Assoc. Med. Bras.

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Introduction: Pelvic floor muscle training (PFMT) involves the contraction of the puborectal, anal sphincter and external urethral muscles, inhibiting the detrusor contraction, what justify its use in the treatment of overactive bladder (OAB) symptoms. Objective: To verify the effects of isolated PFMT on the symptoms of OAB. Method: Prospective clinical trial with 27 women with mixed urinary incontinence (MUI), with predominance of OAB symptoms and loss ≥ 2 g in the pad test. It was evaluated: pelvic floor muscles (PFMs) function (digital palpation and manometry); urinary symptoms (nocturia, frequency and urinary loss); degree of discomfort of OAB symptoms; and quality of life (Incontinence Quality-ofLife Questionnaire [I-QoL]). The PFMT program consisted of 24 outpatient sessions (2x/week + home PFMT). The Mann-Whitney and Wilcoxon tests (with a significance level of 5%) were used to analyse the data. Results: There was a significant improvement of the urinary symptoms to the pad test (5.8±9.7, p<0.001), urinary loss (0.7±1.1, p=0.005) and nocturia (0.8±0.9, p=0.011). Reduction in the degree of discomfort of urinary symptoms was observed according to OAB-V8 questionnaire (10.0±7.7, p=0.001). There were also significant results in PFMs function: Oxford (3.6±0.9, p=0.001), endurance (5.2±1.8, p<0.001), fast (8.9±1.5, p<0.001) and manometry (26.6±15.8, p=0.003).In addition, quality of life had a significant improvement in the three domains evaluated by I-QoL. Conclusion: The PFMT without any additional guidelines improves the symptomatology, the function of PFMs and the quality of life of women with OAB symptoms.

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“…The etiology of diabetic OAB is still not well-recognized, but the genesis of OAB in diabetes has been thought to develop with the central or/and peripheral nerve damage; for example, DO as a result of diabetic cerebral vasculopathy or/and increased bladder sensation because of peripheral nerve irritation (20,21). On the other hand, peripheral nerve damage in diabetic cerebral vasculopathy with decreased bladder capacity and presence of mimic OAB (22). Metabolic syndrome can be an etiologic pathway for the onset of OAB (23,24).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Overactive Bladder in Type 2 Diabetes Patients with a Questionaire-Based Study

Verim¹,

Kayataş²,

Abanonu³

et al. 2016

Haseki

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Abs tractAim: Overactive bladder (OAB) is a common and well-known urologic condition. OAB occurs in both women and men. Diabetes mellitus (DM) is one of the most common metabolic disorders in the world and the prevalence of DM in adults has been increasing. Diabetic neuropathy can induce functional disease of multiple organs, including diabetic bladder dysfunction (DBD). DBD occurs commonly as a late complication and DBD is mainly characterized by poor bladder emptying, urinary retention and overflow incontinence. However, storage symptoms, as those suggestive for OAB may also affect people with DM. The aim of this study was to evaluate the prevalence of OAB in people with DM compared to healthy control subjects. Methods: We analyzed records of 212 diabetic case and 229 control subjects using the 8-item symptom bother scale of the OAB questionnaire (OAB-q) (OAB-V8). Results:Diabetic bladder overactivity was seen in 20.3% of patients with DM (n=43) and 10.5% of non-diabetic control group (n=24). The OAB prevalence in patients with DM was approximately two-fold higher than in control subjects. OAB increased with the duration of diabetes, glycosylated hemoglobin level and age. There was no significant difference in sex distribution between the groups. There is an increase in the prevalence type 2 diabetes in Turkey. DM is a common cause of reduced bladder sensation in both men and women. In this study, OAB syndrome in diabetic patients was searched. DBD is characterized by underactive (flaccid) bladder, voiding difficulty, infrequent voiding and reduced bladder sensation during urinary storage; bladder underactivity and urinary retention during urination. OAB in diabetic patients is characterized by urgency (a compelling and sudden desire to void), with or without incontinence, usually with urinary frequency and nocturia. Conclusion: OAB symptoms are more prevalent in diabetic people than in healthy people. OAB symptoms in DM may be considered as a predictor of the development of diabetic neuropathy. Thus, controlling the progression of DM might reduce the incidence of diabetic neuropathy and other late diabetic complications.

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Overactive Bladder: A Better Understanding of Pathophysiology, Diagnosis and Management

Abstract: Behavioral therapy combined with pharmacological therapy often will bring about acceptable outcomes for patients with OAB. Modalities such as botulinum toxin injections, neuromodulation, and various surgical interventions also are showing encouraging results in more refractory patients.

Cited by 158 publications

References 24 publications

Beyond the Lower Urinary Tract: The Association of Urologic and Sexual Symptoms with Common Illnesses

Beyond the Lower Urinary Tract: The Association of Urologic and Sexual Symptoms with Common Illnesses

Pelvic floor muscle training for overactive bladder symptoms – A prospective study

Evaluation of Overactive Bladder in Type 2 Diabetes Patients with a Questionaire-Based Study

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