Bschleipfer T, Wagenlehner F M, Lüdecke G, Pilatz A, Weidner W
Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Justus-Liebig-Universität Gießen, Rudolf-Buchheim-Straße 7, 35385 Gießen, Deutschland.
Urologe A. 2013 Jun;52(6):800-4. doi: 10.1007/s00120-013-3153-1.
The prevalence of overactive bladder syndrome (OAB) increases with age and is associated with a clear reduction in patient quality of life. Age-related alterations of the urinary bladder as well as increased occurrence of neurological and non-neurological diseases with age contribute to the onset of OAB. Antimuscarinic drugs are the medication of choice; however, restricted tolerability and polypharmacotherapy limit administration in the elderly. Extended release preparations are to be favored as constant intake of medication is more feasible and adverse effects occur less often compared to immediate release formulations. With respect to cognitive impairment newly introduced substances and quaternary amines seem to be advantageous. However, constipation remains a notable side effect in older patients. Intravesical botulinum toxin type A (BoNT/A) injections are an alternative and a therapeutic escalation in patients suffering from OAB. Adverse events are very rare and drug interactions are unknown; however, injections can result in hypercontinence causing the necessity for artificial urine drainage.
膀胱过度活动症（OAB）的患病率随年龄增长而增加，且与患者生活质量明显下降相关。膀胱的年龄相关改变以及随着年龄增长神经和非神经疾病发生率的增加导致了OAB的发病。抗毒蕈碱药物是首选药物；然而，耐受性受限和多药治疗限制了其在老年人中的应用。缓释制剂更受青睐，因为与速释制剂相比，持续服药更可行且不良反应发生频率更低。就认知障碍而言，新引入的物质和季铵类药物似乎更具优势。然而，便秘在老年患者中仍然是一个显著的副作用。膀胱内注射A型肉毒杆菌毒素（BoNT/A）是OAB患者的一种替代治疗方法和治疗升级手段。不良事件非常罕见且药物相互作用尚不清楚；然而，注射可能导致尿失禁加重，从而需要进行人工导尿。
