Department of Urology, University of Michigan, Ann Arbor, Michigan.
Department of Urology, Columbia University, New York, New York.
Neurourol Urodyn. 2024 Nov;43(8):1742-1752. doi: 10.1002/nau.25532. Epub 2024 Jul 15.
The purpose of this guideline is to provide evidence-based guidance to clinicians of all specialties on the evaluation, management, and treatment of idiopathic overactive bladder (OAB). The guideline informs the reader on valid diagnostic processes and provides an approach to selecting treatment options for patients with OAB through the shared decision-making process, which will maximize symptom control and quality of life, while minimizing adverse events and burden of disease.
An electronic search employing OVID was used to systematically search the MEDLINE and EMBASE databases, as well as the Cochrane Library, for systematic reviews and primary studies evaluating diagnosis and treatment of OAB from January 2013 to November 2023. Criteria for inclusion and exclusion of studies were based on the Key Questions and the populations, interventions, comparators, outcomes, timing, types of studies and settings (PICOTS) of interest. Following the study selection process, 159 studies were included and were used to inform evidence-based recommendation statements.
This guideline produced 33 statements that cover the evaluation and diagnosis of the patient with symptoms suggestive of OAB; the treatment options for patients with OAB, including Noninvasive therapies, pharmacotherapy, minimally invasive therapies, invasive therapies, and indwelling catheters; and the management of patients with BPH and OAB.
Once the diagnosis of OAB is made, the clinician and the patient with OAB have a variety of treatment options to choose from and should, through shared decision-making, formulate a personalized treatment approach taking into account evidence-based recommendations as well as patient values and preferences.
本指南的目的是为所有专业的临床医生提供关于特发性过度活动膀胱(OAB)的评估、管理和治疗的循证指导。该指南告知读者有效的诊断过程,并通过共同决策过程为 OAB 患者提供选择治疗方案的方法,从而最大限度地控制症状和提高生活质量,同时最小化不良反应和疾病负担。
采用 OVID 电子搜索,系统检索了 MEDLINE 和 EMBASE 数据库以及 Cochrane 图书馆,以评估 2013 年 1 月至 2023 年 11 月期间 OAB 的诊断和治疗的系统评价和原始研究。研究纳入和排除标准基于关键问题以及感兴趣的人群、干预措施、比较因素、结局、时间、研究类型和设置(PICOTS)。在研究选择过程之后,纳入了 159 项研究,并用于提供基于证据的推荐陈述。
本指南共产生了 33 条陈述,涵盖了有 OAB 症状的患者的评估和诊断;OAB 患者的治疗选择,包括非侵入性治疗、药物治疗、微创治疗、侵入性治疗和留置导管;以及 BPH 和 OAB 患者的管理。
一旦诊断出 OAB,临床医生和 OAB 患者就有多种治疗选择可供选择,并且应该通过共同决策,制定个性化的治疗方法,既要考虑基于证据的建议,也要考虑患者的价值观和偏好。