Cardozo Linda
Urogynaecology Department, King's College Hospital, London, UK.
Can Urol Assoc J. 2011 Oct;5(5 Suppl 2):S139-42. doi: 10.5489/cuaj.11185.
Although the prevalence of overactive bladder (OAB) is similar in both male and female populations, females have a greater tendency to seek medical advice regarding their symptoms. A review of the evidence of therapy among women shows that a variety of modalities has been shown to be effective for symptom improvement in women with OAB. Bladder retraining/re-education should be considered for all women with OAB. With respect to first-line pharmacotherapy with antimuscarinic agents, the development of extended release preparations, bladder selective M3 antagonists and alternative routes of delivery, have improved compliance and persistence. Other pharmacotherapeutic options with potential for providing benefit include antidepressants, vasopressin analogues, alpha-adrenoceptor antagonists and beta-adrenoceptor agonists. There are also a number of newer agents currently being investigated, including calcium channel blocking agents, potassium channel opening drugs, beta agonists and neurokinin receptor antagonists. Intravesical injections of botulinum toxin may be an alternative, while surgery can be considered for truly intractable cases.
尽管膀胱过度活动症（OAB）在男性和女性人群中的患病率相似，但女性更倾向于就其症状寻求医疗建议。对女性治疗证据的回顾表明，多种治疗方式已被证明对改善OAB女性的症状有效。所有OAB女性都应考虑膀胱再训练/再教育。关于抗毒蕈碱药物的一线药物治疗，缓释制剂、膀胱选择性M3拮抗剂和替代给药途径的开发，提高了依从性和持续性。其他可能有益的药物治疗选择包括抗抑郁药、血管加压素类似物、α-肾上腺素能受体拮抗剂和β-肾上腺素能受体激动剂。目前也有一些新型药物正在研究中，包括钙通道阻滞剂、钾通道开放药物、β激动剂和神经激肽受体拮抗剂。膀胱内注射肉毒杆菌毒素可能是一种替代方法，而对于真正难治的病例可考虑手术治疗。
