Overactive bladder

Overactive bladder (OAB) is a symptom syndrome including urinary urgency with or without urinary incontinence, usually with frequency and nocturia. Urgency, defined as the compelling feeling of impending incontinence that is difficult to defer, is the cornerstone symptom of OAB. The diagnosis is based on symptoms alone and assumes no underlying pathology. Approximately 12.2% of the adult population experience OAB in Korea. The syndrome is now recognized as a chronic debilitating condition that negatively affects the quality of life. Often the patients have a restricted social life and an increased risk for depression. Despite increased awareness in recent years, OAB remains an underreported condition. Continued evolution of our understanding of the pathophysiology of OAB has identified contributory mechanisms, which has in turn established structured evidence-based managements. Treatment of OAB is aimed at relief of symptoms and improving quality of life. Conservative treatments combined with antimuscarinic drugs are the main treatment for OAB. There are many antimuscarinic available, with several under development, which have different specificities for the muscarinic receptors. Other drugs have also been tried but with limited success. Behavioral therapy combined with pharmacological therapy often will bring about acceptable outcomes for patients with OAB. Modalities such as botulinum toxin injections, neuromodulation, and various surgical interventions also are showing encouraging results in more refractory patients. Further research into the basic science of the condition is required to identify the true cause of OAB, allowing new targeted treatments to be established.