Del Popolo Giulio, Mencarini Marco, Li Marzi Vincenzo
Neuro-Urologia, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy.
Urologia. 2012;79(1):6-13. doi: 10.5301/RU.2012.9032.
The prevalence of overactive bladder (OAB) in adult males varies from 10.2% to 17.4%, and in females from 7.7 to 31.3. 16.5% of the adult population presents symptoms consistent with OAB; of these, 37.2% are actually affected. The OAB has a significant effect on the quality of life. Initial treatment includes behavioral therapy, physiotherapy and antimuscarinic drugs. In patients where behavioral modifications fail, treatment is associated with antimuscarinics. The antimuscarinic agents used to treat OAB showed some efficacy, but adverse events too, such as dry mouth, constipation, headache and blurred vision. In selected cases unresponsive to antimuscarinic therapy, it is possible to use second-line treatments represented by sacral neuromodulation and botulinum toxin type A both for idiopathic detrusor overactivity, where it is still an experimental treatment, and for neurogenic cases with 2011 FDA approval. Surgical options represent the last choice for selected cases.
成年男性膀胱过度活动症（OAB）的患病率在10.2%至17.4%之间，成年女性的患病率在7.7%至31.3%之间。16.5%的成年人口出现与OAB相符的症状；其中，37.2%的人实际受到影响。OAB对生活质量有重大影响。初始治疗包括行为疗法、物理疗法和抗毒蕈碱药物。对于行为改变无效的患者，治疗采用抗毒蕈碱药物。用于治疗OAB的抗毒蕈碱药物显示出一定疗效，但也有不良事件，如口干、便秘、头痛和视力模糊。在对抗毒蕈碱治疗无反应的特定病例中，对于特发性逼尿肌过度活动（仍属实验性治疗）以及2011年获得美国食品药品监督管理局（FDA）批准的神经源性病例，可使用以骶神经调节和A型肉毒杆菌毒素为代表的二线治疗方法。手术选择是特定病例的最后选择。
