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Management of Overactive Bladder in the Young Man

  • Overactive Bladder (U Lee and S Adelstein, Section Editors)
  • Published:
Current Bladder Dysfunction Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

In this review, the current literature regarding idiopathic overactive bladder (OAB) in the young male will be discussed. We will also share the unique experience of providers at a single military institution in treating this specific patient population and their recommendations based on the unique etiologies, comorbidities, and treatment response and adherence.

Recent Findings

Despite several studies addressing idiopathic OAB and providing the basis for existing guidelines, none offer guidance on how this syndrome affects a younger male population in whom OAB is less likely to be due to an obstructive etiology, nor is there guidance on the optimal approach to efficient assessment and management in this patient population.

Summary

Adherence to the American Urological Association guidelines with more liberal use of adjunctive diagnostic measures with early escalation of therapy when symptoms are not adequately controlled may expedite OAB symptom management more appropriately in young men. Prospective studies focusing on OAB treatment in this patient population are needed to better understand and better treat OAB in this patient population.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.

  2. Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50(6):1306–14 discussion 14-5.

  3. Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20(6):327–36.

    CAS  PubMed  Google Scholar 

  4. Coyne KS, Sexton CC, Vats V, Thompson C, Kopp ZS, Milsom I. National community prevalence of overactive bladder in the United States stratified by sex and age. Urology. 2011;77(5):1081–7.

    Article  PubMed  Google Scholar 

  5. Milsom I, Abrams P, Cardozo L, Roberts RG, Thüroff J, Wein AJ. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int. 2001;87(9):760–6.

    Article  CAS  PubMed  Google Scholar 

  6. Coyne KS, Matza LS, Kopp ZS, Thompson C, Henry D, Irwin DE, et al. Examining lower urinary tract symptom constellations using cluster analysis. BJU Int. 2008;101(10):1267–73.

  7. Coyne KS, Wein AJ, Tubaro A, Sexton CC, Thompson CL, Kopp ZS, et al. The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS. BJU Int. 2009;103(Suppl 3):4–11.

  8. Coyne KS, Sexton CC, Kopp ZS, Ebel-Bitoun C, Milsom I, Chapple C. The impact of overactive bladder on mental health, work productivity and health-related quality of life in the UK and Sweden: results from EpiLUTS. BJU Int. 2011;108(9):1459–71.

    Article  PubMed  Google Scholar 

  9. Abrams P, Kelleher CJ, Kerr LA, Rogers RG. Overactive bladder significantly affects quality of life. Am J Manag Care. 2000;6(11 Suppl):S580–90.

    CAS  PubMed  Google Scholar 

  10. Coyne KS, Sexton CC, Irwin DE, Kopp ZS, Kelleher CJ, Milsom I. The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study. BJU Int. 2008;101(11):1388–95.

    Article  PubMed  Google Scholar 

  11. Wein AJ, Coyne KS, Tubaro A, Sexton CC, Kopp ZS, Aiyer LP. The impact of lower urinary tract symptoms on male sexual health: EpiLUTS. BJU Int. 2009;103(Suppl 3):33–41.

    Article  PubMed  Google Scholar 

  12. Sexton CC, Coyne KS, Vats V, Kopp ZS, Irwin DE, Wagner TH. Impact of overactive bladder on work productivity in the United States: results from EpiLUTS. Am J Manag Care. 2009;15(4 Suppl):S98–S107.

    PubMed  Google Scholar 

  13. Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132(3):474–9.

    Article  CAS  PubMed  Google Scholar 

  14. Al-Azzawi IS, Al-Tamimi MAJ. The first Iraqi experience in sacral neuromodulation for patients with lower urinary tract dysfunction. Arab J Urol. 2018;16(4):391–6.

    Article  PubMed  PubMed Central  Google Scholar 

  15. de Groat WC. A neurologic basis for the overactive bladder. Urology. 1997;50(6A Suppl):36–52 discussion 3-6.

    Article  PubMed  Google Scholar 

  16. Brading AF. Spontaneous activity of lower urinary tract smooth muscles: correlation between ion channels and tissue function. J Physiol. 2006;570(Pt 1):13–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Drake MJ, Mills IW, Gillespie JI. Model of peripheral autonomous modules and a myovesical plexus in normal and overactive bladder function. Lancet. 2001;358(9279):401–3.

    Article  CAS  PubMed  Google Scholar 

  18. Andersson KE. Detrusor myocyte activity and afferent signaling. Neurourol Urodyn. 2010;29(1):97–106.

    Article  PubMed  Google Scholar 

  19. Gormley EA, Lightner DJ, Faraday M, Vasavada SP, Association AU. Society of Urodynamics FmPM. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol. 2015;193(5):1572–80.

    Article  PubMed  Google Scholar 

  20. Wood SK, Baez MA, Bhatnagar S, Valentino RJ. Social stress-induced bladder dysfunction: potential role of corticotropin-releasing factor. Am J Physiol Regul Integr Comp Physiol. 2009;296(5):R1671–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Smith AL, Leung J, Kun S, Zhang R, Karagiannides I, Raz S, et al. The effects of acute and chronic psychological stress on bladder function in a rodent model. Urology. 2011;78(4):967.e1–7.

    Article  PubMed  Google Scholar 

  22. Huang CL, Wu MP, Ho CH, Wang JJ. The bidirectional relationship between anxiety, depression, and lower urinary track symptoms: a nationwide population-based cohort study. J Psychosom Res. 2017;100:77–82.

    Article  PubMed  Google Scholar 

  23. Steers W. Overactive bladder, urge incontinence and emotional disorders. In: AUA Update Series; 2008.

    Google Scholar 

  24. • Breyer BN, Kenfield SA, Blaschko SD, Erickson BA. The association of lower urinary tract symptoms, depression and suicidal ideation: data from the 2005-2006 and 2007-2008 National Health and Nutrition Examination Survey. J Urol. 2014;191(5):1333–9. Shows how mental health diagnoses are frequently found to be comorbid conditions with the OAB complex and often have a bidirectional relationship with LUTS. In our small cohort, we found that nearly all our patients suffered from a mental health diagnosis. It is the authors' opinion that to successfully manage the OAB symptoms, equal effort must be made to ensure the mental health diagnoses are being addressed and managed as well. This relationship remains to be further understood; however appears to affect younger patients with LUTS than our older patients.

  25. • Breyer BN, Cohen BE, Bertenthal D, Rosen RC, Neylan TC, Seal KH. Lower urinary tract dysfunction in male Iraq and Afghanistan war veterans: association with mental health disorders: a population-based cohort study. Urology. 2014;83(2):312–9. Shows how mental health diagnoses are frequently found to be comorbid conditions with the OAB complex and often have a bidirectional relationship with LUTS. In our small cohort, we found that nearly all our patients suffered from a mental health diagnosis. It is the authors' opinion that to successfully manage the OAB symptoms, equal effort must be made to ensure the mental health diagnoses are being addressed and managed as well. This relationship remains to be further understood; however appears to affect younger patients with LUTS than our older patients.

  26. •• Lightner DJ, Agarwal D, Gormley EA. The overactive bladder and the AUA guidelines: a proposed clinical pathway for evaluation and effective management in a contemporary urology practice. Urology Practice. 2016;3(5):399–405. Contains the AUA guidelines on OAB and AUA/SUFU guidelines on adult urodynamics and remain the mainstay for how we should approach the OAB complex.

  27. • Collins CW, Winters JC, Association AU, Reconstruction SoUFPMaU. AUA/SUFU adult urodynamics guideline: a clinical review. Urol Clin North Am. 2014;41(3):353–62 vii. Contains the AUA guidelines on OAB and AUA/SUFU guidelines on adult urodynamics and remain the mainstay for how we should approach the OAB complex.

  28. Hashim H, Abrams P. How should patients with an overactive bladder manipulate their fluid intake? BJU Int. 2008;102(1):62–6.

    Article  PubMed  Google Scholar 

  29. Lohsiriwat S, Hirunsai M, Chaiyaprasithi B. Effect of caffeine on bladder function in patients with overactive bladder symptoms. Urol Ann. 2011;3(1):14–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Shafik A, Shafik IA. Overactive bladder inhibition in response to pelvic floor muscle exercises. World J Urol. 2003;20(6):374–7.

    PubMed  Google Scholar 

  31. Robinson D, Cardozo L. Antimuscarinic drugs to treat overactive bladder. BMJ. 2012;344:e2130.

    Article  CAS  PubMed  Google Scholar 

  32. Peeker R, Samsioe G, Kowalski J, Andersson AS, Bergqvist A. A prospective observational study of the effects of treatment with extended-release tolterodine on health-related quality of life of patients suffering overactive bladder syndrome in Sweden. Scand J Urol Nephrol. 2010;44(3):138–46.

    Article  CAS  PubMed  Google Scholar 

  33. Sexton CC, Notte SM, Maroulis C, Dmochowski RR, Cardozo L, Subramanian D, et al. Persistence and adherence in the treatment of overactive bladder syndrome with anticholinergic therapy: a systematic review of the literature. Int J Clin Pract. 2011;65(5):567–85.

  34. Sebastianelli A, Russo GI, Kaplan SA, McVary KT, Moncada I, Gravas S, et al. Systematic review and meta-analysis on the efficacy and tolerability of mirabegron for the treatment of storage lower urinary tract symptoms/overactive bladder: comparison with placebo and tolterodine. Int J Urol. 2018;25(3):196–205.

    Article  CAS  PubMed  Google Scholar 

  35. Maman K, Aballea S, Nazir J, Desroziers K, Neine ME, Siddiqui E, et al. Comparative efficacy and safety of medical treatments for the management of overactive bladder: a systematic literature review and mixed treatment comparison. Eur Urol. 2014;65(4):755–65.

  36. Kelleher C, Hakimi Z, Zur R, Siddiqui E, Maman K, Aballéa S, et al. Efficacy and tolerability of mirabegron compared with antimuscarinic monotherapy or combination therapies for overactive bladder: a systematic review and network meta-analysis. Eur Urol. 2018;74(3):324–33.

  37. Zinner N, Kobashi KC, Ebinger U, Viegas A, Egermark M, Quebe-Fehling E, et al. Darifenacin treatment for overactive bladder in patients who expressed dissatisfaction with prior extended-release antimuscarinic therapy. Int J Clin Pract. 2008;62(11):1664–74.

  38. Zinner N, Noe L, Rasouliyan L, Marshall T, Seifeldin R. Impact of solifenacin on resource utilization, work productivity and health utility in overactive bladder patients switching from tolterodine ER. Curr Med Res Opin. 2008;24(6):1583–91.

    Article  CAS  PubMed  Google Scholar 

  39. Wong C, Duggan P. Solifenacin for overactive bladder in women unsuccessfully treated with immediate release oxybutynin: a pilot study. J Obstet Gynaecol. 2009;29(1):31–4.

    Article  CAS  PubMed  Google Scholar 

  40. Zhang F, Zhao S, Shen B, Wang J, Nelson DE, Roppolo JR, et al. Neural pathways involved in sacral neuromodulation of reflex bladder activity in cats. Am J Physiol Renal Physiol. 2013;304(6):F710–7.

  41. Xiao Z, Rogers MJ, Shen B, Wang J, Schwen Z, Roppolo JR, et al. Somatic modulation of spinal reflex bladder activity mediated by nociceptive bladder afferent nerve fibers in cats. Am J Physiol Renal Physiol. 2014;307(6):F673–9.

  42. Wang Y, Hassouna MM. Neuromodulation reduces c-fos gene expression in spinalized rats: a double-blind randomized study. J Urol. 2000;163(6):1966–70.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Naval Medical Center San Diego, 34800 Bob Wilson Dr., San Diego, CA, 92134, USA

    Christine M. Herforth, Colin A. McLain & Chong Jay Choe

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  1. Christine M. Herforth
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  2. Colin A. McLain
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Correspondence to Christine M. Herforth.

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Conflict of Interest

Dr. Herforth and Dr. McLain declare that they have no conflict of interest. Dr. Choe participates as a Center of Excellence on behalf of Medtronic for the implantation technique of SNS. The US Navy, Naval Medical Center San Diego, and Dr. Choe cannot and do not accept any financial gains or fees for participation as a Center of Excellence.

The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government.

The authors are military service members. This work was prepared as part of their official duties. Title 17, U.S.C. §105 provides that copyright protection under this title is not available for any work of the U.S. Government. Title 17, U.S.C., §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Overactive Bladder

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Herforth, C.M., McLain, C.A. & Choe, C.J. Management of Overactive Bladder in the Young Man. Curr Bladder Dysfunct Rep 14, 205–213 (2019). https://doi.org/10.1007/s11884-019-00528-5

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