Overactive bladder (OAB) is the term given to the symptom complex of urinary frequency and urgency, with or without urge incontinence. OAB may have a significant impact on the quality of life of an individual and has considerable economic impact on society. Recent epidemiological studies, which have included patients without incontinence, suggest that the prevalence of OAB is much higher than previously expected. OAB may be treated in a variety of ways, the mainstay being conservative methods such as behavioral changes, physiotherapy, and most commonly, pharmacotherapy. Recent advances in pharmacotherapy have introduced new agents and delivery systems that have increased tolerability and compliance without compromising efficacy.
This supplement to Reviews in Urology, titled Strategies for the Treatment of Overactive Bladder and Urinary Incontinence, is based on presentations from a recent roundtable meeting of opinion leaders held in New York. All of the authors are recognized internationally as experts in the area of OAB. Their contributions are succinct and scientifically valid, as well as clinically practical. They provide up-to-date information and expert opinions regarding OAB. In the opening article, Victor Nitti discusses the prevalence of OAB, its effect on quality of life, associated comorbidities, and economic impact. This is followed by an elegant presentation by William Steers on the pathophysiology of OAB and urge incontinence. Next, treatments for are OAB are discussed, starting with Roger Dmochowski’s comprehensive review of interventions for detrusor overactivity, from conservative to surgical. Supplementing Dr. Dmochowski’s article is a review of biofeedback by Pat O’Donnell. Following this, Rodney Appell and colleagues discuss medical therapy. OAB is particularly prevalent in the elderly, and its diagnosis and treatment are complicated by many factors unique to this population. Gopal Badlani highlights this in his article, “Treatment of Overactive Bladder and Incontinence in the Elderly.” Then, John Voytas discusses the role of the geriatrician and primary care physician in the treatment of OAB. Finally, Michael Chancellor “looks into his crystal ball” in “New Frontiers in the Treatment of Overactive Bladder and Incontinence” and discusses future therapies.