Management of the overactive bladder: a review of pharmacological therapies and methods used by the urological specialist.

Overactive bladder is a common urological diagnosis, which is often untreated as patients fail to seek help for this embarrassing problem. This disorder causes significant lifestyle limitations for the patient and is also expensive as it reduces national productivity and therefore affected patients should be treated. It is simple for primary care providers to make a working diagnosis in this disorder and they should be carrying out simple investigations in order to make the diagnosis. Commencement of therapy should start with conservative measures such as lifestyle modifications including pelvic floor exercises and bladder drill followed by the introduction of pharmacological treatments if necessary. The patient should be fully educated about their disorder and about the potential side effects of the medication they are given in order to improve compliance. There are a number of antimuscarinics available on the market for the treatment of overactive bladder but it is often difficult to decide which is the best form of management for these patients. In this review we address the necessary investigations that need to be carried out as well as providing an overview of the different non-surgical and medical treatments for this common problem. Should these therapies fail, then the referral to a urological specialist should be made prior to invasive therapy.