Maastricht University Medical Centre, Maastricht, The Netherlands.
University Hospitals of Leicester National Health Service Trust, Leicester, UK.
Eur Urol Focus. 2019 Nov;5(6):1112-1119. doi: 10.1016/j.euf.2018.03.011. Epub 2018 Apr 4.
Overactive bladder syndrome (OAB) is a prevalent disorder with a significant impact on quality of life. Despite this high prevalence, there is significant underdiagnosis and undertreatment due to several barriers, including embarrassment, poor communication and low patient adherence. Currently, various antimuscarinic are available in the treatment of OAB. The introduction of mirabegron has broadened the therapeutic approach and combination therapy of both agents can be valuable in clinical practice. Yet, patient adherence to most drugs for OAB is still relatively poor. Healthcare providers need to identify and utilise strategies to improve treatment adherence by defining clear treatment goals, implement educational methods and frequently communicate with patients to identify problems with adherence. The elderly population form need special attention as in these patients, anticholinergics should be prescribed with care and adequate knowledge regarding pharmacokinetics and drug interactions in essential. Furthermore, patient expectations should be clearly discussed. In this narrative review, the current advances in oral pharmacotherapy are evaluated and the most important factors involved in the management of OAB are discussed.
膀胱过度活动症（OAB）是一种普遍存在的疾病，对生活质量有重大影响。尽管这种疾病的患病率很高，但由于多种障碍，包括尴尬、沟通不畅和患者依从性低，导致诊断不足和治疗不足。目前，有多种抗毒蕈碱药物可用于治疗 OAB。米拉贝隆的引入拓宽了治疗方法，两种药物的联合治疗在临床实践中可能具有价值。然而，大多数治疗 OAB 的药物的患者依从性仍然相对较差。医疗保健提供者需要通过明确治疗目标、实施教育方法以及经常与患者沟通以确定依从性问题，来识别和利用策略来提高治疗依从性。老年人群体需要特别关注，因为在这些患者中，应谨慎使用抗胆碱能药物，并充分了解药代动力学和药物相互作用等方面的知识。此外，还应明确讨论患者的期望。在这篇叙述性综述中，评估了口服药物治疗的最新进展，并讨论了管理 OAB 涉及的最重要因素。
