Management of urinary incontinence in women with overactive bladder in urologist daily practice Review article
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Published:
Jun 30, 2021
Keywords:
mirabegron, β3 agonist, pharmacological therapy, overactive bladder, female urinary incontinence
Main Article Content
Abstract
Urinary incontinence urinary incontinence is common among women and contributes to decreased quality of life. Several effective treatment options are available for the most common types of urinary incontinence (stress, urge, and mixed), including lifestyle modification and behavioral technique, drug therapy, and minimally invasive procedures. Most women improve with treatment, and urinary incontinence is not an inevitable part of aging. To maximize the opportunity for successful treatment, it is essential to align the therapeutic approach with patient goals and expectations for care, including an assessment of patient-driven priorities regarding potential adverse effects, costs, and expected benefit of different treatment approaches. There are many unique challenges in treating an overactive bladder in older women, such as functional and cognitive impairment, multimorbidity, polypharmacy, and estrogen deficiency, all of which contribute to treating symptoms in older women. This review highlights the current understanding of age-related changes in bladder function and proposes specific clinical considerations for overactive bladder management specific to older women.
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How to Cite
Wiatr , T., & Chłosta , P. (2021). Management of urinary incontinence in women with overactive bladder in urologist daily practice. Medycyna Faktow (J EBM), 14(2(51), 169-175. https://doi.org/10.24292/01.MF.0221.5
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References
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30. Rosa G, Ferrero S, Nitti V et al. Cardiovascular safety of β3-adrenoceptor agonists for the treatment of patients with overactive bladder. Eur Urol. 2016; 69(2): 311-23.
31. Yamaguchi O, Chapple CR. Beta3-adrenoceptors in urinary bladder. Neurourol Urodyn. 2007; 26(6): 752-6.
32. Wagg A. Antimuscarinic treatment in overactive bladder: special considerations in elderly patients. Drugs Aging. 2012; 29(7): 539-48.
33. Burton C, Sajja A, Latthe PM. Effectiveness of percutaneous posterior tibial nerve stimulation for overactive bladder: a systematic review and meta-analysis. Neurourol Urodyn. 2012; 31(8): 1206-16.
34. Averbeck MA, Gomes CM. Worldwide Utilization Patterns of Sacral Neuromodulation for Neurogenic Lower Urinary Tract Dysfunction. Current Bladder Dysfunction Reports. 2016; 11: 356-64.
35. Amundsen CL, Webster GD. Sacral neuromodulation in an older, urge incontinent population. Am J Obstet Gynecol. 2002; 187(6): 1462-5.
36. Miotla P, Cartwright R, Skorupska K et al. Urinary retention in female OAB after intravesical Botox injection: who is really at risk. Int Urogynecol J. 2017; 28(6): 845-50.
37. Liao C, Kuo H. Increased risk of large post-void residual urine and decreased long-term success rate after intravesical onabotulinumtoxinA injection for refractory idiopathic detrusor overactivity. J Urol. 2013; 189(5): 1804-10.
2. Wu JM, Vaughan CP, Goode PS et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol. 2014; 123: 141-8.
3. Milsom I, Altman D, Cartwright R et al. Epidemiology of urinary incontinence and other lower urinary tract symptoms, pelvic organ prolapse and anal incontinence. International Continence Society, Bristol 2017.
4. Brown JS, Vittinghoff E, Wyman JF et al. Urinary incontinence: does it increase risk for falls and fractures? Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc. 2000; 48(7): 721-5.
5. Minassian VA, Hagan KA, Erekson E et al. The natural history of urinary incontinence subtypes in the Nurses’ Health Studies. Am J Obstet Gynecol. 2020; 222(2): 163.e1-163e.8.
6. Kelleher CJ, Kreder KJ, Pleil AM et al. Longterm health-related quality of life of patients receiving extended release tolterodine for overactive bladder. Am J Manag Care. 2002; 8: S616-S30.
7. Sacco E, Tienforti D, D’Addessi A et al. Social, economic, and health utility considerations in the treatment of overactive bladder. Open Access J Urol. 2010; 2: 11-24.
8. Sacco E. Physiopathology of overactive bladder syndrome. Urologia. 2012; 79(1): 24-35.
9. Tadic SD, Griffiths D, Schaefer W et al. Brain activity underlying impaired continence control in older women with overactive bladder. Neurourol Urodyn. 2012; 31(5): 652-8.
10. Ketai LH, Komesu YM, Dodd AB et al. Urgency urinary incontinence and the interoceptive network: a functional magnetic resonance imaging study. Am J Obstet Gynecol. 2016; 215(4): 449.e1-449.e17.
11. Brading A, Symes S. Ischemia as an etiological factor in bladder instability: implications for therapy. Adv Exp Med Biol. 2003; 539(Pt A): 255-69.
12. Yoshida M, Miyamae K, Iwashita H et al. Management of detrusor dysfunction in the elderly: changes in acetylcholine and adenosine triphosphate release during aging. Urology. 2004; 63(3 suppl 1): 17-23.
13. Iosif S, Batra S, Ek A et al. Estrogens receptors in the human female lower urinary tract. Am J Obstet Gynaecol. 1981; 141(7): 817-20.
14. Robinson D, Cardoza L, Milsom I et al. Oestrogens and overactive bladder. Neurourol Urodynam. 2014; 33(7): 1086-91.
15. Gomez-Amaya SM, Ruggieri MR, Arias Serrato SA et al. Gross anatomical study of the nerve supply of genitourinary structures in female mongrel hound dogs. Anat Histol Embryol. 2014; 44: 118-27.
16. Haylen BT, de Ridder D, Freeman RM et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010; 29: 4-20.
17. Roosen A, Chapple CR, Dmochowski RR et al. A refocus on the bladder as the originator of storage lower urinary tract symptoms: a systematic review of the latest literature. Eur Urol. 2009; 56(5): 810-9.
18. Enck P, Aziz Q, Barbara G et al. Irritable bowel syndrome. Nat Rev Dis Primers. 2016; 2: 16014.
19. Li M, Sun Y, Simard JM et al. Increased transient receptor potential vanilloid type 1 (TRPV1) signaling in idiopathic overactive bladder urothelial cells. Neurourol Urodyn. 2011; 30: 606-11.
20. Burgio KL. Update on behavioral and physical therapies for incontinence and overactive bladder: the role of pelvic floor muscle training. Curr Urol Rep. 2013; 14(5): 457-64.
21. Fonda D, Abrams P. Cure sometimes, help always – a “continence paradigm” for all ages and conditions. Neurourol Urodyn. 2006; 25(3): 290-2.
22. Tak EC, van Hespen A, van Dommelen P et al. Does improved functional performance help to reduce urinary incontinence in institutionalized older women? A multicenter randomized clinical trial. BMC Geriatr. 2012; 12: 51.
23. Burgio KL, Goode PS, Locher JL et al. Behavioral training with and without biofeedback in the treatment of urge incontinence in older women: a randomized controlled trial. JAMA. 2002; 288(18): 2293-9.
24. Griffiths D, Clarkson B, Tadic SD et al. Brain Mechanisms Underlying Urge Incontinence and its Response to Pelvic Floor Muscle Training. J Urol. 2015; 194(3): 708-15.
25. Fox C, Richardson K, Maidman I et al. Anticholinergic medication and use and cognitive impairment in the older population: the medical research council cognitive function and aging study. J Am Geriatr Soc. 2011; 59(8): 1477-83.
26. Riva D, Casolati E. Oxybutynin chloride in the treatment of female idiopathic bladder instability. Results from double blind treatment. Clin Exp Obstet Gynecol. 1984; 11(1-2): 37-42.
27. Chapple C, Van Kerrebroeck P, Tubaro A et al. Clinical efficacy, safety, and tolerability of once-daily fesoterodine in subjects with overactive bladder. Eur Urol. 2007; 52(4): 1204-12. http://doi.org/10.1016/j.eururo.2007.07.009.
28. Sexton CC, Notte SM, Maroulis C et al. Persistence and adherence in the t reatment of overactive bladder syndrome with anticholinergic therapy: a systematic review of the literature. Int J Clin Pract. 2011; 65(5): 567-85. http://doi.org/10.1111/j.1742-1241.2010.02626.x.
29. Wagg A, Dale M, Tretter R et al. Randomised, multicentre, placebo-controlled, double-blind crossover study investigating the effect of solifenacin and oxybutynin in elderly people with mild cognitive impairment: the SENIOR study. Eur Urol. 2013; 64(1): 74-81. http://doi.org/10.1016/j.eururo.2013.01.002.
30. Rosa G, Ferrero S, Nitti V et al. Cardiovascular safety of β3-adrenoceptor agonists for the treatment of patients with overactive bladder. Eur Urol. 2016; 69(2): 311-23.
31. Yamaguchi O, Chapple CR. Beta3-adrenoceptors in urinary bladder. Neurourol Urodyn. 2007; 26(6): 752-6.
32. Wagg A. Antimuscarinic treatment in overactive bladder: special considerations in elderly patients. Drugs Aging. 2012; 29(7): 539-48.
33. Burton C, Sajja A, Latthe PM. Effectiveness of percutaneous posterior tibial nerve stimulation for overactive bladder: a systematic review and meta-analysis. Neurourol Urodyn. 2012; 31(8): 1206-16.
34. Averbeck MA, Gomes CM. Worldwide Utilization Patterns of Sacral Neuromodulation for Neurogenic Lower Urinary Tract Dysfunction. Current Bladder Dysfunction Reports. 2016; 11: 356-64.
35. Amundsen CL, Webster GD. Sacral neuromodulation in an older, urge incontinent population. Am J Obstet Gynecol. 2002; 187(6): 1462-5.
36. Miotla P, Cartwright R, Skorupska K et al. Urinary retention in female OAB after intravesical Botox injection: who is really at risk. Int Urogynecol J. 2017; 28(6): 845-50.
37. Liao C, Kuo H. Increased risk of large post-void residual urine and decreased long-term success rate after intravesical onabotulinumtoxinA injection for refractory idiopathic detrusor overactivity. J Urol. 2013; 189(5): 1804-10.