Skip to main content

Advertisement

Log in

Evaluation and Management of Urgency and Urge Urinary Incontinence in Men

  • Voiding Dysfunction Evaluation (JT Anger, Section Editor)
  • Published:
Current Bladder Dysfunction Reports Aims and scope Submit manuscript

Abstract

The overactive bladder (OAB) syndrome is increasingly being recognized as a major contributor to the lower urinary tract symptoms in men previously thought to be only due to bladder outlet obstruction from benign prostatic hyperplasia. Medical and surgical treatments that have historically been used to treat women with OAB are being applied to men with great efficacy and a good safety profile. Additionally, treatments such as the β-3 agonist mirabegron, phosphodiesterase-5 inhibitors, sacral and peripheral neuromodulation, and intravesical botulinum toxin injection are promising emerging therapies for the OAB syndrome. This review discusses the evaluation of the male patient with OAB symptoms such as urgency and urge incontinence, and explores the different therapeutic options available for management of men with OAB.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

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

  1. Milsom I, Abrams P, Cardozo L, et al. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int. 2001;87:760–6.

    Article  PubMed  CAS  Google Scholar 

  2. Hyman MJ, Groutz A, Blaivas JG. Detrusor instability in men: correlation of lower urinary tract symptoms with urodynamic findings. J Urol. 2001;166:550–2.

    Article  PubMed  CAS  Google Scholar 

  3. Herbison P, Hay-Smith J, Ellis G, et al. Effectiveness of anticholinergic drugs compared with placebo in the treat- ment of overactive bladder: systematic review. BMJ. 2004;326:841–4.

    Article  Google Scholar 

  4. •• Nitti V, Herschorn S, Auerbach S, et al. The selective beta-3 adrenoreceptor agonist mirabegron is effective and well tolerated in patients with overactive bladder syndrome. AUA 2011 abstract 1958. This double-blinded, placebo-controlled trial establishes mirabegron as the first new class of drugs for the OAB syndrome in a number of years.

  5. Nitti V, Herschorn S, Auerbach S, et al. Mirabegron improves patient-reported outcomes in patients with overactive bladder syndrome – results from a North-American study. AUA 2011 abstract 1959.

  6. Resnick NM, Yalla SV. Detrusor hyperactivity with impaired contractile function: an unrecognized but common cause of incontinence in elderly patients. JAMA. 1987;257:3076–81.

    Article  PubMed  CAS  Google Scholar 

  7. Athanasopoulos A, Gyftopoulos K, Giannitsas K, et al. Combination treatment with an alpha-blocker plus an anticholinergic for bladder outlet obstruction: a prospective, randomized, controlled study. J Urol. 2003;169:2253–6.

    Article  PubMed  CAS  Google Scholar 

  8. Van Venrooij GE, Van Melick HH, Eckhardt MD, et al. Correlations of urodynamic changes with changes in symptoms and well-being after transurethral resection of the prostate. J Urol. 2002;168:605–9.

    Article  PubMed  Google Scholar 

  9. •• Gacci M, Eardley I, Giuliano F, et al. Critical analysis of the relationship between sexual dysfunctions and lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2011;60:809–25. This is an excellent review article highlighting why PDE5i are effective in the treatment of both LUTS and erectile dysfunction, explaining the common pathogenesis of the two diseases.

    Article  PubMed  Google Scholar 

  10. Fibbi B, Morelli A, Vignozzi L, et al. Characterization of phosphodiesterase type 5 expression and functional activity in the human male lower urinary tract. J Sex Med. 2010;7:59–69.

    Article  PubMed  CAS  Google Scholar 

  11. Morelli A, Chavalmane AK, Filippi S, et al. Atorvastatin ameliorates sildenafil-induced penile erections in experimental diabetes by inhibiting diabetes-induced RhoA/Rho-kinase signaling hyperactivation. J Sex Med. 2009;6:91–106.

    Article  PubMed  CAS  Google Scholar 

  12. Morelli A, Filippi S, Sandner P, et al. Vardenafil modulates bladder contractility through cGMP-mediated inhibition of RhoA/Rho kinase signaling pathway in spontaneously hypersensitive rats. J Sex Med. 2009;6:1594–608.

    Article  PubMed  CAS  Google Scholar 

  13. Kaplan S, Gonzalez R, Te A. Combination of alfuzosin and sildenafil is superior to monotherapy in treating lower urinary tract symptoms and erectile dysfunction. Eur Urol. 2007;51:1717–23.

    Article  PubMed  CAS  Google Scholar 

  14. Ng C, Gonzalez R, Te A. Refractory overactive bladder in men: update on novel therapies. Curr Urol Rep. 2006;7:456–61.

    Article  PubMed  Google Scholar 

  15. Yoshida M, Inadome A, Maeda Y. Non-neuronal cholinergic system in human bladder urothelium. Urology. 2006;67:425–30.

    Article  PubMed  Google Scholar 

  16. Ehren I, Volz D, Farrelly E, et al. Efficacy and impact of botulinum toxin A on quality of life in patients with neurogenic detrusor overactivity: a randomized, placebo-controlled, double-blind study. Scand J Urol Nephrol. 2007;41:335–40.

    Article  PubMed  CAS  Google Scholar 

  17. •• Mangera A, Andersson K, Apostolidis A, et al. Contemporary management of lower urinary tract disease with botulinum toxin A: a systematic review of Botox (onabotulinumtoxinA) and Dysport (abobotulinumtoxinA). Eur Urol. 2011;60:784–95. This is an excellent review article highlighting botulinum toxin’s efficacy on several different LUTS, both neurogenic and non-neurogenic.

    Article  PubMed  CAS  Google Scholar 

  18. Tincello D, Slack M, Kenyon S, et al. Botulinum toxin-A for refractor detrusor overactivity in women: a 240 patient randomized placebo controlled trial [abstract 581]. Eur Urol Suppl. 2011;10:191.

    Article  Google Scholar 

  19. Flynn M, Amundsen C, Perevich M, et al. Outcome of a randomized, double-blind, placebo controlled trial of botulinum A toxin for refractory overactive bladder. J Urol. 2009;181:2608–15.

    Article  PubMed  CAS  Google Scholar 

  20. Jonas U, Fowler C, Chancellor M, et al. Eficacy of sacral nerve stimulation for urinary retention: results 18 months after implantation. J Urol. 2001;165:15–9.

    Article  PubMed  CAS  Google Scholar 

  21. • Occhino J, Siegel S. Sacral nerve modulation in overactive bladder. Curr Urol Rep. 2010;11:348–52. This is a thorough review article discussing the indications for treatment with sacral neuromodulation and its efficacy in several different cases.

    Article  PubMed  Google Scholar 

  22. Groen J, Ruud Bosch J, van Mastrigt R. Sacral neuromodulation in women with idiopathic detrusor overactivity incontinence: decreased overactivity but unchanged bladder contraction strength and urethral resistance during voiding. J Urol. 2006;175:1005–9.

    Article  PubMed  Google Scholar 

  23. Peters K, Carrico D, Perez-Marrero R, et al. Randomized trial of percutaneous tibial nerve stimulation versus sham efficacy in the treatment of overactive bladder syndrome: Results from the SUmiT trial. J Urol. 2010;183:1438–43.

    Article  PubMed  Google Scholar 

Download references

Disclosure

Dr. Gonzalez has served on the speakers’ bureau for Allergan, Eli Lilly and Company, Astellas, and Watson Pharmaceuticals, and has developed educational slides for Eli Lilly and Company.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ricardo R. Gonzalez.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hollander, A.B., Gonzalez, R.R. Evaluation and Management of Urgency and Urge Urinary Incontinence in Men. Curr Bladder Dysfunct Rep 7, 230–234 (2012). https://doi.org/10.1007/s11884-012-0143-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11884-012-0143-x

Keywords

Navigation