Treatment approaches for overactive bladder syndrome in women produce modest results
(4 September 2009: VIDYYA MEDICAL NEWS SERVICE) -- Drug therapy and behavior interventions produce modest results in reducing overactive bladder symptoms in women, according to a new evidence report by HHS’ Agency for Healthcare Research and Quality.
Behavioral interventions, which may include pelvic muscle exercises and training the bladder by steadily increasing the time between bathroom visits are modestly effective in reducing incontinence associated with overactive bladder syndrome. The results produced by these behavior modifications are similar to the impact of drugs, such as, oxybutynin, tolterodine, darifenacin, trospium, solifenacin, and festoterodine. Quality of life and satisfaction measures suggest that even modest improvements can be important to women.
About 11 million women in the United States cope on a daily basis with overactive bladder syndrome. Symptoms include sudden strong urges to urinate, difficulty delaying going to the bathroom, and in many cases involuntary loss of urine when the urge strikes. Researchers led by Katherine Hartmann, MD, PhD of the AHRQ-supported Vanderbilt University Evidence-based Practice Center, reviewed research evidence on treatments for overactive bladder. These treatments include prescription medications, both pills and patches; surgeries and procedures, behavioral interventions, and complementary and alternative medicine, such as acupuncture, hypnotherapy and reflexology.
Drug therapy was found to be modestly effective at improving one or more overactive bladder symptoms; however, there is no evidence to determine the long-term effectiveness of the drugs. Behavioral interventions yielded results similar to drug therapy in reducing symptoms of overactive bladder. Researchers found little evidence to support the effectiveness of complementary and alternative therapies. Procedural and surgical treatments, such as sacral nerve stimulation (neuromodulation), and bladder instillation or injections, were found to treat symptoms in select groups of women though more information is needed to understand safety and effectiveness.
The American Urological Association nominated the topic of the evidence report because it is interested in developing guidelines for women with overactive bladder symptoms. To review the report, go to: http://www.ahrq.gov/clinic/tp/bladdertp.htm
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