ISSN: 1305-3876
Hakkında: Özel sayılar şeklinde yayınlanır.
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Overactive Bladder Syndrome (obs)
Dr. Tufan TARCANa
aÜroloji AD, Marmara Üniversitesi Tıp Fakültesi, İSTANBUL
OBS is a symptomatic definition characterized with frequency, urgency or urge incontinence where no local, metabolical or hormonal abnormality exists to explain the overactivity. Although urodynamic studies are not mandatory for the diagnosis of OBS, they may be of utmost importance in selected cases to reach the correct diagnosis and to plan the appropriate treatment. Controversies still exist on the terminology of idiopathic overactive bladder symptoms. It is obvious that OBS does not fit to the definition of a “syndrome”. A better understanding of the pathophysiology of overactive bladder symptoms in the future may necessitate further changes in the current terminology.
The prevalence of overactive bladder symptoms is about 17% and their incidence is increasing with aging. Overactive bladder symptoms decrease the quality of life by their social, sexual and psychological effects and produce a huge burden in the health economy. The most common target in the treatment of OBS is the detrusor muscle and the most commonly used modality is the anticholinergic treatment. The overall market of anticholinergic medications world-wide has reached 6.11 billion US Dollars per year. The main disadvantage of antimuscarinic drugs is high treatment withdrawal rates due to systemic side effects. Therefore, more bladder-specific molecules are certainly needed in treatment of OBS. When combined with medical treatment, modification of life style and diet, timely voiding and pelvic floor exercises can further improve the success of anticholinergic treatment. When oral medical and conservative treatments fail, intravesical treatment options and several neuromodulation techniques may be tried. The last step in the treatment of OBS is the bladder augmentation surgery which remains to be the gold standard if conservative, medical and minimally invasive treatment modalities not succeedKeywords: Overactive bladder, anticholinergic treatment,urinary incontinenceTurkiye Klinikleri J Surg Med Sci 2005, 1(5):49-55
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