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Conservative Management and Behavioral Modifications for Overactive Bladder

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Abstract

Overactive bladder is a chronic condition that has significant effects on quality of life. Management of this condition often emphasizes the use of anticholinergic therapy. However, there are often intolerable side effects that result in poor compliance with these medications. Conservative management and behavioral modification are effective management tools as initial therapies or in conjunction with medical therapy. This review focuses on nonpharmacologic therapies and their role in the management of overactive bladder.

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References

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

  1. Abrams, P., Cardozo, L., Fall, M. et al.: The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Am J Obstet Gynecol, 187: 116, 2002.

    Article  PubMed  Google Scholar 

  2. Stewart, W. F., Van Rooyen, J. B., Cundiff, G. W. et al.: Prevalence and burden of overactive bladder in the United States. World J Urol, 20: 327, 2003.

    CAS  PubMed  Google Scholar 

  3. Dmochowski, R.: Improving the tolerability of anticholinergic agents in the treatment of overactive bladder. Drug Saf, 28: 583, 2005.

    Article  CAS  PubMed  Google Scholar 

  4. Kelleher, C. J., Kreder, K. J., Pleil, A. M. et al.: Long-term health-related quality of life of patients receiving extended-release tolterodine for overactive bladder. Am J Manag Care, 8: S616, 2002.

    PubMed  Google Scholar 

  5. Abrams, P., Kelleher, C. J., Kerr, L. A. et al.: Overactive bladder significantly affects quality of life. Am J Manag Care, 6: S580, 2000.

    CAS  PubMed  Google Scholar 

  6. Komaroff, A. L., Fagioli, L. R., Doolittle, T. H. et al.: Health status in patients with chronic fatigue syndrome and in general population and disease comparison groups. Am J Med, 101: 281, 1996.

    Article  CAS  PubMed  Google Scholar 

  7. Brown, J. S., Vittinghoff, E., Wyman, J. F. et al.: Urinary incontinence: does it increase risk for falls and fractures? Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc, 48: 721, 2000.

    CAS  PubMed  Google Scholar 

  8. Kelleher, C. J., Cardozo, L. D., Khullar, V. et al.: A medium-term analysis of the subjective efficacy of treatment for women with detrusor instability and low bladder compliance. Br J Obstet Gynaecol, 104: 988, 1997.

    Article  CAS  PubMed  Google Scholar 

  9. • Pelletier, E. M., Vats, V., Clemens, J. Q.: Pharmacotherapy adherence and costs versus nonpharmacologic management in overactive bladder. Am J Manag Care, 15: S108, 2009. This paper addresses socioeconomic factors that are important in the management of OAB, including cost and rates of noncompliance.

    PubMed  Google Scholar 

  10. Swithinbank, L., Hashim, H., Abrams, P.: The effect of fluid intake on urinary symptoms in women. J Urol, 174: 187, 2005.

    Article  CAS  PubMed  Google Scholar 

  11. Hashim, H., Abrams, P.: How should patients with an overactive bladder manipulate their fluid intake? BJU Int, 102: 62, 2008.

    Article  PubMed  Google Scholar 

  12. Zimmern, P., Litman, H. J., Mueller, E. et al.: Effect of fluid management on fluid intake and urge incontinence in a trial for overactive bladder in women. BJU Int, 105: 1680.

  13. Williams, M. E., Pannill, F. C., 3rd: Urinary incontinence in the elderly: physiology, pathophysiology, diagnosis, and treatment. Ann Intern Med, 97: 895, 1982.

    CAS  PubMed  Google Scholar 

  14. Dowd, T. T., Campbell, J. M., Jones, J. A.: Fluid intake and urinary incontinence in older community-dwelling women. J Community Health Nurs, 13: 179, 1996.

    Article  CAS  PubMed  Google Scholar 

  15. Schneider, T., Marschall-Kehrel, D., Hanisch, J. U. et al.: Do gender, age or lifestyle factors affect responses to antimuscarinic treatment in overactive bladder patients? Int J Clin Pract, 64: 1287.

  16. Arya, L. A., Myers, D. L., Jackson, N. D.: Dietary caffeine intake and the risk for detrusor instability: a case-control study. Obstet Gynecol, 96: 85, 2000.

    Article  CAS  PubMed  Google Scholar 

  17. Tomlinson, B. U., Dougherty, M. C., Pendergast, J. F. et al.: Dietary caffeine, fluid intake and urinary incontinence in older rural women. Int Urogynecol J Pelvic Floor Dysfunct, 10: 22, 1999.

    Article  CAS  PubMed  Google Scholar 

  18. Bryant, C. M., Dowell, C. J., Fairbrother, G.: Caffeine reduction education to improve urinary symptoms. Br J Nurs, 11: 560, 2002.

    PubMed  Google Scholar 

  19. Dallosso, H. M., McGrother, C. W., Matthews, R. J. et al.: The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in women. BJU Int, 92: 69, 2003.

    Article  CAS  PubMed  Google Scholar 

  20. Dallosso, H. M., Matthews, R. J., McGrother, C. W. et al.: The association of diet and other lifestyle factors with the onset of overactive bladder: a longitudinal study in men. Public Health Nutr, 7: 885, 2004.

    Article  PubMed  Google Scholar 

  21. Shiri, R., Hakama, M., Hakkinen, J. et al.: The effects of lifestyle factors on the incidence of nocturia. J Urol, 180: 2059, 2008.

    Article  PubMed  Google Scholar 

  22. Hannestad, Y. S., Rortveit, G., Daltveit, A. K. et al.: Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. Bjog, 110: 247, 2003.

    PubMed  Google Scholar 

  23. Dasgupta, J., Elliott, R. A., Doshani, A. et al.: Enhancement of rat bladder contraction by artificial sweeteners via increased extracellular Ca2+ influx. Toxicol Appl Pharmacol, 217: 216, 2006.

    Article  CAS  PubMed  Google Scholar 

  24. Okada, S., Kojima, Y., Hamamoto, S. et al.: Dietary soy isoflavone replacement improves detrusor overactivity of ovariectomized rats with altered connexin-43 expression in the urinary bladder. BJU Int, 103: 1429, 2009.

    Article  CAS  PubMed  Google Scholar 

  25. Huang, Y. C., Shindel, A. W., Ning, H. et al.: Adipose derived stem cells ameliorate hyperlipidemia associated detrusor overactivity in a rat model. J Urol, 183: 1232.

  26. Vella, V. L., Jaffe, W., Lidicker, J. et al.: Prevalence of urinary symptoms in morbidly obese women and changes after bariatric surgery. J Reprod Med, 54: 597, 2009.

    PubMed  Google Scholar 

  27. Bump, R. C., Sugerman, H. J., Fantl, J. A. et al.: Obesity and lower urinary tract function in women: effect of surgically induced weight loss. Am J Obstet Gynecol, 167: 392, 1992.

    CAS  PubMed  Google Scholar 

  28. Auwad, W., Steggles, P., Bombieri, L. et al.: Moderate weight loss in obese women with urinary incontinence: a prospective longitudinal study. Int Urogynecol J Pelvic Floor Dysfunct, 19: 1251, 2008.

    Article  PubMed  Google Scholar 

  29. Subak, L. L., Wing, R., West, D. S. et al.: Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med, 360: 481, 2009.

    Article  CAS  PubMed  Google Scholar 

  30. Holmes, D. M., Stone, A. R., Bary, P. R. et al.: Bladder training–3 years on. Br J Urol, 55: 660, 1983.

    Article  CAS  PubMed  Google Scholar 

  31. Wallace, S. A., Roe, B., Williams, K. et al.: Bladder training for urinary incontinence in adults. Cochrane Database Syst Rev: CD001308, 2004.

  32. Payne, C.: Wein: Campbell-Walsh Urology, 9th ed. Chapter 63—Conservative management of urinary incontinence: behavioral and pelvic floor therapy, urethral and pelvic devices. Pelvic floor rehabilitation, 9th ed. Orlando, Fl: WB Saunders Company, 2007.

    Google Scholar 

  33. Patil, A., Duckett, J. R.: Effect of prolapse repair on voiding and bladder overactivity. Curr Opin Obstet Gynecol, 22: 399.

  34. • de Boer TA, Salvatore S., Cardozo L, Chapple C, Kelleher C, van Kerrebroeck P, Kirby MG, Koelbl H, Espuna-Pons M, Milsom I, Tubaro A, Wagg A, Vierhout ME.: Pelvic organ prolapse and overactive bladder.. Neurourol Urodyn, 29: 30, 2010. This is a good review of recent literature focusing on management of pelvic organ prolapse and OAB.

    Article  PubMed  Google Scholar 

  35. Clemons, J. L., Aguilar, V. C., Tillinghast, T. A. et al.: Patient satisfaction and changes in prolapse and urinary symptoms in women who were fitted successfully with a pessary for pelvic organ prolapse. Am J Obstet Gynecol, 190: 1025, 2004.

    Article  PubMed  Google Scholar 

  36. Fernando, R. J., Thakar, R., Sultan, A. H. et al.: Effect of vaginal pessaries on symptoms associated with pelvic organ prolapse. Obstet Gynecol, 108: 93, 2006.

    Article  PubMed  Google Scholar 

  37. Hanson, L. A., Schulz, J. A., Flood, C. G. et al.: Vaginal pessaries in managing women with pelvic organ prolapse and urinary incontinence: patient characteristics and factors contributing to success. Int Urogynecol J Pelvic Floor Dysfunct, 17: 155, 2006.

    Article  CAS  PubMed  Google Scholar 

  38. Shafik, A., Shafik, A. A., Shafik, I. A. et al.: The electromyographic activity of the external and internal urethral sphincters and urinary bladder on vaginal distension and its role in preventing vaginal soiling with urine during sexual intercourse. Arch Gynecol Obstet, 277: 213, 2008.

    Article  PubMed  Google Scholar 

  39. Wilson PD, Berghmans B., Hagen S. : Incontinence. Adult conservative management. Paris: Health Publications Ltd, 2005.

    Google Scholar 

  40. Cammu, H., Van Nylen, M., Amy, J. J.: A 10-year follow-up after Kegel pelvic floor muscle exercises for genuine stress incontinence. BJU Int, 85: 655, 2000.

    Article  CAS  PubMed  Google Scholar 

  41. Brubaker, L., Benson, J. T., Bent, A. et al.: Transvaginal electrical stimulation for female urinary incontinence. Am J Obstet Gynecol, 177: 536, 1997.

    Article  CAS  PubMed  Google Scholar 

  42. Arruda, R. M., Castro, R. A., Sousa, G. C. et al.: Prospective randomized comparison of oxybutynin, functional electrostimulation, and pelvic floor training for treatment of detrusor overactivity in women. Int Urogynecol J Pelvic Floor Dysfunct, 19: 1055, 2008.

    Article  PubMed  Google Scholar 

  43. Yamanishi, T., Sakakibara, R., Uchiyama, T. et al.: Comparative study of the effects of magnetic versus electrical stimulation on inhibition of detrusor overactivity. Urology, 56: 777, 2000.

    Article  CAS  PubMed  Google Scholar 

  44. Herbison, P., Plevnik, S., Mantle, J.: Weighted vaginal cones for urinary incontinence. Cochrane Database Syst Rev: CD002114, 2002.

  45. Wang, A. C., Wang, Y. Y., Chen, M. C.: Single-blind, randomized trial of pelvic floor muscle training, biofeedback-assisted pelvic floor muscle training, and electrical stimulation in the management of overactive bladder. Urology, 63: 61, 2004.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Jennifer T. Anger.

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Khan, A., Anger, J.T. Conservative Management and Behavioral Modifications for Overactive Bladder. Curr Bladder Dysfunct Rep 6, 13–19 (2011). https://doi.org/10.1007/s11884-010-0076-1

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