Current Bladder Dysfunction Reports

, Volume 12, Issue 1, pp 58–65 | Cite as

Patient Satisfaction on Overactive Bladder Treatment

  • Kimberly Tay
  • Aqsa KhanEmail author
Overactive Bladder (U Lee, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Overactive Bladder


Purpose of Review

The purpose of this review is to review recent literature with regard to patient satisfaction with overactive bladder treatments.

Recent Findings

The latest research looks into beta-3 agonist, Mirabegron, to treat OAB and sacral and pudendal neuromodulation for severe OAB.


Conservative management effectively alleviated OAB symptoms without the adverse effects of antimuscarinic medications. PFME appears to be the most successful treatment. Medical management continues to show efficacy but with very bothersome side effects in a substantial proportion of patients and with significant cost, leading to medical noncompliance and discontinuation of therapy. BTX-A injections and neuromodulation also are quite efficacious as a third-line treatment option for refractory OAB patients or patients who are no longer candidates for second-line therapy.


Overactive bladder Patient satisfaction Anticholinergics Neuromodulation 


Compliance with Ethical Standards

Conflict of Interest

Kimberly Tay and Dr. Aqsa Khan both declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

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


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

  1. 1.
    • Marinkovic SP, Rovner ES, Moldwin RM, Stanton SL, Gillen LM, Marinkovic CM. The management of overactive bladder syndrome. BMJ. 2012;344:e2365. Reviews overactive bladder management.PubMedCrossRefGoogle Scholar
  2. 2.
    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.PubMedGoogle Scholar
  3. 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. Article discuss the burden of overactive bladder within the US.PubMedGoogle Scholar
  4. 4.
    Milsom I, Abrams P, Cardozo L, Roberts RG, Thuroff 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.PubMedCrossRefGoogle Scholar
  5. 5.
    Kobelt-Nguyen G, Johanesson M, Mattiasson A, et al. Correlations between symptoms of urge incontinence and scores of a generic quality of life instrument (SF-36) and health status measurement (Euro-QoL) and between changes in symptoms and QoL scores [abstract]. Presented at the 27th Annual Meeting of The International Continence Society; September 23–26, 1997; Yokohama, Japan.Google Scholar
  6. 6.
    Komaroff AL, Fagioli LR, Doolittle TH, et al. Health status in patients with chronic fatigue syndrome and in general population disease comparison groups. Am J Med. 1996;101:281–90 [PubMed].PubMedCrossRefGoogle Scholar
  7. 7.
    Abrams P, Wein AJ. The Overactive Bladder: A Widespread but Treatable Condition. Stockholm, Sweden: Erik Sparre Medical AB; 1998.Google Scholar
  8. 8.
    Nazir J, Posnett J, Walker A, Odeyemi IA, Hakimi Z, Garnham A. Economic evaluation of pharmacological treatments for overactive bladder from the perspective of the UK National Health Service. J Med Econ. 2015;18(5):390–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Burgio KL, Goode PS, Johnson TM, Hammontree L, Ouslander JG, Markland AD, et al. Behavioral versus drug treatment for overactive bladder in men: the Male Overactive Bladder Treatment in Veterans (MOTIVE) Trial. J Am Geriatr Soc. 2011;59(12):2209–16.PubMedCrossRefGoogle Scholar
  10. 10.
    Burgio KL. Update on behavioral and physical therapies for incontinence and overactive bladder: the role of pelvic floor muscle training. Curr Urol Rep. 2013;14(5):457–64.PubMedCrossRefGoogle Scholar
  11. 11.
    Yuce T, Dokmeci F, Cetinkaya SE. A prospective randomized trial comparing the use of tolterodine or weighted vaginal cones in women with overactive bladder syndrome. Eur J Obstet Gynecol Reprod Biol. 2016;197:91–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Aydogmus Y, Sunay M, Arslan H, Aydin A, Adiloglu AK, Sahin H. Acupuncture versus solifenacin for treatment of overactive bladder and its correlation with urine nerve growth factor levels: a randomized, placebo-controlled clinical trial. Urol Int. 2014;93(4):437–43.PubMedCrossRefGoogle Scholar
  13. 13.
    Yuan Z, He C, Yan S, Huang D, Wang H, Tang W. Acupuncture for overactive bladder in female adult: a randomized controlled trial. World J Urol. 2015;33(9):1303–8.PubMedCrossRefGoogle Scholar
  14. 14.
    •• Gormley EA, Lightner DJ, Faraday M, Vasavada SP, American Urological Association, Society of Urodynamics, Female Pelvic Medicine. Diagnosis and treatment of overactive bladder non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol. 2015;193(5):1572–80. AUA/SUFU guidelines for overactive bladder management and proides an algorithm on how to manage patients and taking into account the quality of service.PubMedCrossRefGoogle Scholar
  15. 15.
    Gras J. Mirabegron for the treatment of overactive bladder. Drugs Today (Barc). 2012;48(1):25–32.CrossRefGoogle Scholar
  16. 16.
    Aaron LE, Morris TJ, Jahshan P, Reiz JL. An evaluation of patient and physician satisfaction with controlled-release oxybutynin 15 mg as a one-step daily dose in elderly and non-elderly patients with overactive bladder: results of the STOP study. Curr Med Res Opin. 2012;28(8):1369–79.PubMedCrossRefGoogle Scholar
  17. 17.
    Yamaguchi O, Uchida E, Higo N, Minami H, Kobayashi S, Sato H, et al. Efficacy and safety of once-daily oxybutynin patch versus placebo and propiverine in Japanese patients with overactive bladder: a randomized double-blind trial. Int J Urol. 2014;21(6):586–93.PubMedCrossRefGoogle Scholar
  18. 18.
    Sand PK, Davila GW, Lucente VR, Thomas H, Caramelli KE, Hoel G. Efficacy and safety of oxybutynin chloride topical gel for women with overactive bladder syndrome. Am J Obstet Gynecol. 2012;206(2):168.e1–6.CrossRefGoogle Scholar
  19. 19.
    Gittelman M, Weiss H, Seidman L. A phase 2, randomized, double-blind, efficacy and safety study of oxybutynin vaginal ring for alleviation of overactive bladder symptoms in women. J Urol. 2014;191(4):1014–21.PubMedCrossRefGoogle Scholar
  20. 20.
    Wagg A, Khullar V, Marschall-Kehrel D, Michel MC, Oelke M, Darekar A, et al. Flexible-dose fesoterodine in elderly adults with overactive bladder: results of the randomized, double-blind, placebo-controlled study of fesoterodine in an aging population trial. J Am Geriatr Soc. 2013;61(2):185–93.PubMedCrossRefGoogle Scholar
  21. 21.
    Sand PK, Heesakkers J, Kraus SR, Carlsson M, Guan Z, Berriman S. Long-term safety, tolerability and efficacy of fesoterodine in subjects with overactive bladder symptoms stratified by age: pooled analysis of two open-label extension studies. Drugs Aging. 2012;29(2):119–31.PubMedCrossRefGoogle Scholar
  22. 22.
    DuBeau CE, Morrow JD, Kraus SR, Creanga D, Bavendam T. Efficacy and tolerability of fesoterodine versus tolterodine in older and younger subjects with overactive bladder: a post hoc, pooled analysis from two placebo-controlled trials. Neurourol Urodyn. 2012;31(8):1258–65.PubMedCrossRefGoogle Scholar
  23. 23.
    Crosby RD, Mathias SD, Marshall TS. Relationships between symptoms, symptom bother, and health-related quality of life in patients with overactive bladder taking solifenacin or placebo in the VIBRANT study. Int J Clin Pract. 2011;65(2):211–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Ercan O, Kostu B, Bakacak M, Aytac-Tohma Y, Coskun B, Avci F, et al. Comparison of solifenacin and fesoterodine in treatment of overactive bladder. Saudi Med J. 2015;36(10):1181–5.PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    But I, Goldstajn MS, Oreskovic S. Comparison of two selective muscarinic receptor antagonists (solifenacin and darifenacin) in women with overactive bladder--the SOLIDAR study. Coll Antropol. 2012;36(4):1347–53.PubMedGoogle Scholar
  26. 26.
    Akino H, Namiki M, Suzuki K, Fuse H, Kitagawa Y, Miyazawa K, et al. Factors influencing patient satisfaction with antimuscarinic treatment of overactive bladder syndrome: results of a real-life clinical study. Int J Urol. 2014;21(4):389–94.PubMedCrossRefGoogle Scholar
  27. 27.
    Lee KS, Park B, Kim JH, Kim HG, Seo JT, Lee JG, et al. A randomised, double-blind, parallel design, multi-institutional, non-inferiority phase IV trial of imidafenacin versus fesoterodine for overactive bladder. Int J Clin Pract. 2013;67(12):1317–26.PubMedCrossRefGoogle Scholar
  28. 28.
    Herschorn S, Barkin J, Castro-Diaz D, Frankel JM, Espuna-Pons M, Gousse AE, et al. A phase III, randomized, double-blind, parallel-group, placebo-controlled, multicentre study to assess the efficacy and safety of the beta(3) adrenoceptor agonist, mirabegron, in patients with symptoms of overactive bladder. Urology. 2013;82(2):313–20.PubMedCrossRefGoogle Scholar
  29. 29.
    Nitti VW, Khullar V, van Kerrebroeck P, Herschorn S, Cambronero J, Angulo JC, et al. Mirabegron for the treatment of overactive bladder: a prespecified pooled efficacy analysis and pooled safety analysis of three randomised, double-blind, placebo-controlled, phase III studies. Int J Clin Pract. 2013;67(7):619–32.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Khullar V, Amarenco G, Angulo JC, Cambronero J, Hoye K, Milsom I, et al. Efficacy and tolerability of mirabegron, a beta(3)-adrenoceptor agonist, in patients with overactive bladder: results from a randomised European-Australian phase 3 trial. Eur Urol. 2013;63(2):283–95.PubMedCrossRefGoogle Scholar
  31. 31.
    Abrams P, Kelleher C, Staskin D, Rechberger T, Kay R, Martina R, et al. Combination treatment with mirabegron and solifenacin in patients with overactive bladder: efficacy and safety results from a randomised, double-blind, dose-ranging, phase 2 study (Symphony). Eur Urol. 2015;67(3):577–88.PubMedCrossRefGoogle Scholar
  32. 32.
    Fowler CJ, Auerbach S, Ginsberg D, Hale D, Radziszewski P, Rechberger T, et al. OnabotulinumtoxinA improves health-related quality of life in patients with urinary incontinence due to idiopathic overactive bladder: a 36-week, double-blind, placebo-controlled, randomized, dose-ranging trial. Eur Urol. 2012;62(1):148–57.PubMedCrossRefGoogle Scholar
  33. 33.
    Malde S, Dowson C, Fraser O, Watkins J, Khan MS, Dasgupta P, et al. Patient experience and satisfaction with Onabotulinumtoxin A for refractory overactive bladder. BJU Int. 2015;116(3):443–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Dmochowski R, Chapple C, Nitti VW, Chancellor M, Everaert K, Thompson C, et al. Efficacy and safety of onabotulinumtoxinA for idiopathic overactive bladder: a double-blind, placebo controlled, randomized, dose ranging trial. J Urol. 2010;184(6):2416–22.PubMedCrossRefGoogle Scholar
  35. 35.
    Bauer RM, Gratzke C, Roosen A, Hocaoglu Y, Mayer ME, Buchner A, et al. Patient-reported side effects of intradetrusor botulinum toxin type a for idiopathic overactive bladder syndrome. Urol Int. 2011;86(1):68–72.PubMedCrossRefGoogle Scholar
  36. 36.
    Frazier EP, Peters SL, Braverman AS, Ruggieri MRS, Michel MC. Signal transduction underlying the control of urinary bladder smooth muscle tone by muscarinic receptors and beta-adrenoceptors. Naunyn Schmiedebergs Arch Pharmacol. 2008;377(4-6):449–62.PubMedCrossRefGoogle Scholar
  37. 37.
    Peters KM, Carrico DJ, Wooldridge LS, Miller CJ, MacDiarmid SA. Percutaneous tibial nerve stimulation for the long-term treatment of overactive bladder: 3-year results of the STEP study. J Urol. 2013;189(6):2194–201.PubMedCrossRefGoogle Scholar
  38. 38.
    Souto SC, Reis LO, Palma T, Palma P, Denardi F. Prospective and randomized comparison of electrical stimulation of the posterior tibial nerve versus oxybutynin versus their combination for treatment of women with overactive bladder syndrome. World J Urol. 2014;32(1):179–84.PubMedCrossRefGoogle Scholar
  39. 39.
    Manriquez V, Guzman R, Naser M, Aguilera A, Narvaez S, Castro A, et al. Transcutaneous posterior tibial nerve stimulation versus extended release oxybutynin in overactive bladder patients. A prospective randomized trial. Eur J Obstet Gynecol Reprod Biol. 2016;196:6–10.PubMedCrossRefGoogle Scholar
  40. 40.
    Siegel S, Noblett K, Mangel J, Griebling TL, Sutherland SE, Bird ET, et al. Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with InterStim therapy compared to standard medical therapy at 6-months in subjects with mild symptoms of overactive bladder. Neurourol Urodyn. 2015;34(3):224–30.PubMedCrossRefGoogle Scholar
  41. 41.
    Gupta SK. Intention-to-treat concept: a review. Perspect Clin Res. 2011;2(3):109–12. doi: 10.4103/2229-3485.83221.PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Siegel S, Noblett K, Mangel J, Griebling TL, Sutherland SE, Bird ET, et al. Three-year Follow-up Results of a Prospective, Multicenter Study in Overactive Bladder Subjects Treated With Sacral Neuromodulation. Urology 2016 Apr 27.Google Scholar
  43. 43.
    Cameron AP, Anger JT, Madison R, Saigal CS, Clemens JQ. Urologic Diseases in America Project. National trends in the usage and success of sacral nerve test stimulation. J Urol. 2011;185(3):970–5.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Noblett K, Benson K, Kreder K. Detailed analysis of adverse events and surgical interventions in a large prospective trial of sacral neuromodulation therapy for overactive bladder patients. Neurourol Urodyn 2016 Aug 4.Google Scholar
  45. 45.
    Hoag N, Plagakis S, Pillay S, Edwards AW, Gani J. Sacral neuromodulation for refractory overactive bladder after prior intravesical onabotulinumtoxinA treatment. Neurourol Urodyn 2016 Sep 9.Google Scholar
  46. 46.
    Singh R, El Nashar SA, Trabuco EC, Klingele CJ, Gebhart JB, Occhino JA. Comparison of Short Term Outcomes of Sacral Nerve Stimulation and Intradetrusor Injection of OnabotulinumtoxinA (Botox) in Women With Refractory Overactive Bladder. Female Pelvic Med Reconstr Surg. 2015;21(6):369–73.PubMedCrossRefGoogle Scholar
  47. 47.
    Tai C, Wang J, Wang X, De Groat WC, Roppolo JR. Bladder inhibition or voiding induced by pudendal nerve stimulation in chronic spinal cord inured cats. Neurourol Urodyn. 2007;26:570–7.PubMedCrossRefGoogle Scholar
  48. 48.
    Rijkhoff N, Wijkstra H. Urinary bladder control by electrical stimulation. Neurourol Urodyn. 2003;16:39–53.CrossRefGoogle Scholar
  49. 49.
    Possover M. A novel implantation technique for pudendal nerve stimulation for treatment of overactive bladder and urgency incontinence. J Minim Invasive Gynecol. 2014;21(5):888–92.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Division of UrologyUniversity of Arizona College of Medicine-PhoenixPhoenixUSA
  2. 2.Female Pelvic Medicine and Reconstructive Surgery, Department of UrologyMayo ClinicPhoenixUSA

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