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Pharmacologic Management of Overactive Bladder: Practical Options for the Primary Care Physician
Ist Teil von
The American journal of medicine, 2006-03, Vol.119 (3), p.24-28
Ort / Verlag
United States: Elsevier Inc
Erscheinungsjahr
2006
Quelle
Access via ScienceDirect (Elsevier)
Beschreibungen/Notizen
Overactive bladder (OAB) affects millions of people in the United States and is associated with poor health, impaired quality of life, social isolation, and depressive symptoms. Despite the high prevalence of this syndrome, studies show that it is not adequately addressed by the busy primary care physician, who may be preoccupied with management of other chronic diseases perceived as more serious such as heart disease, diabetes mellitus, and hypertension. Pharmacologic flexible-dosing studies with anticholinergic agents offer a relatively simple strategy for optimal management of OAB: physician-initiated, patient-managed dose adjustment. Recent flexible-dosing studies with extended-release oxybutynin, darifenacin, and solifenacin suggest that urge urinary and total incontinence episodes may be reduced significantly with a flexible-dosing strategy. Dose adjustment may improve the therapeutic outcome, facilitating a balance between efficacy and anticholinergic side effects such as dry mouth. Flexible-dosing studies indicate that dry mouth, the adverse effect most frequently seen with the use of anticholinergic agents, seldom leads to study withdrawal. Patient-initiated control of OAB symptoms may be achieved in 1 month by following established protocols.