Physical Agent-Based Treatments for Overactive Bladder: A Review

Abstract

Almost one-fifth of the people in the world experience a decrease in quality of life due to overactive bladder (OAB) syndrome. The main bothersome symptoms are urgency accompanied by urinary frequency and nocturia. This chronic, disabling condition is first managed by reducing fluid intake and pelvic floor muscle training, supplemented with antimuscarinic drugs, if necessary. However, refractory cases often still occur. In more severe cases, invasive surgical interventions can be considered; yet, the success rate is still inconsistent, and there is a high complication rate. This condition is frustrating for patients and challenging for the medical staff involved. Although its pathophysiology has not been fully elucidated, peripheral autonomic somatic and sensory afferent receptors are considered to be involved in this condition. Hence, currently, physical agent-based treatments such as neuromodulation have taken a significant place in the third-line therapy of OAB. The efficacy and safety profiles of electrical and magnetic stimulation continue to evolve. Physical-based agents provide an appealing option owing to their effectiveness and minimal side effects. In addition, more physical therapies using light and shock energy are currently being investigated. Thus, a comprehensive understanding of these modalities is an extremely important aspect to provide the most suitable modalities for patients.

Progress in Functional Urology Reflected in Recent Papers in the Journal of Clinical Medicine

“…Already well-established options include sacral or tibial nerve neurostimulation, which are currently considered third-line treatment options. Some Taiwanese investigators have reviewed such options and concluded that these have high efficacy with minimal side effects [ 16 ]. The limitations of neuromodulation appear to be the need for implantation; although they can be cost-effective in the long term, the upfront cost for the device and its implementation can be high.…”

Special Issue: “Latest Advances on Urinary Incontinence”

“…Cicione et al [28] published a systematic review focusing on patients' preferences and expectations reporting that the ideal medication should be cheap, without risk of cognitive function impairment, and able to reduce daytime urinary frequency and incontinence episodes. Several treatments can be proposed, among them physical and agent-based treatment can be offered to a selective group of patients [29].…”