History and current trends in the treatment of idiopathic overactive bladder

Authors: Habeš D. 1;  Leško D. 1;  Štěpán M. 1;  Špaček J. 2;  Kestřánek J. 1
Authors‘ workplace: Porodnická a gynekologická klinika LF UK a FN Hradec Králové 1;  Urologická klinika LF UK a FN Hradec Králové 2
Published in: Ceska Gynekol 2021; 86(4): 284-290
Category: Review article
doi: 10.48095/cccg2021284


Objective: Historical and current view on the therapy of overactive bladder. Methods: This review summarizes the historical approach and current therapy of overactive bladder. The articles were gathered from Pubmed and Scopus databases. Studies published before December 2020 were used for the review. Results and Conclusion: Overactive bladder is a condition that quite a lot reduces the quality of life of our patients. Our therapeutic approach starts with non-pharmacological treatment, such as pelvic floor exercises. The next step is a pharmacological approach. The entry level drug is trospium. If the effect is not sufficient, propiverine, solifenacin, fesoterodine, darifenacin or mirabegron are used. Electrostimulation or botulinum toxin A application is an option only in cases that didn’t respond to pharmacological treatment. It is safe to say, that in the end, there is a way of reducing the severity of overactive bladder symptoms for every  patient.


overactive bladder – urgency – anticholinergics – mirabegron – electrostimulation – botulinum toxin A


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. Neurourol Urodyn 2002; 21 (2): 167–178. doi: 10.1002/nau.10052.

2. Eapen RS, Radomski SB. Review of the epidemiology of overactive bladder. Res Rep Urol 2016; 8: 71–76. doi: 10.2147/RRU.S102 441.

3. Krhut J. Hyperaktivní močový měchýř. 1. vyd. Praha: Maxdorf 2007: 8–9, 30–31, 67–101.

4. Špaček J, Kalousek I, Jílek P et al. Vybrané kapitoly z gynekologie. 1. vyd. Praha: Mladá Fronta 2018: 341–352.

5. Fletcher SG, Haverkorn RM, Yan J et al. Demographic and urodynamic factors associated with persistent OAB after anterior compartent prolapse repair. Neurourol Urodyn 2010; 29 (8): 1414–1418. doi: 10.1002/nau.20 881.

6. Cardona-Grau D, Spettel S. History of the term “overactive bladder”. Curr Bladder Dysfunct Rep 2014; 9: 48–51. doi: 10.1007/s11884-013-02 18-3.

7. Cohn JA, Brown ET, Reynolds WS et al. An update on the use of transdermal oxybutynin in the management of overactive bladder disorder. Ther Adv Urol 2016; 8 (2): 83–90. doi: 10.1177/1756287215626312.

8. AISLP. 2020 [online]. Dostupné z: https: //www.aislp.cz/.

9. Krhut J, Martan A, Gärtner A et al. Dia­gnostika a léčba hyperaktivního močového měchýře v České republice před pěti lety a dnes. Ceska Gynekol 2012; 77 (3): 205–210.

10. Kasman A, Stave C, Elliott CS. Combination therapy in overactive bladder-untapped research opportunities: a systematic review of the literature. Neurourol Urodyn 2019; 38 (8): 2083–2092. doi: 10.1002/nau.24158.

11. Krhut J, Martan A, Zachoval R et al. Impact of body mass index on treatment efficacy of mirabegron for overactive bladder in females. Eur J Obstet Gynecol Reprod Biol 2016; 196: 64–68. doi: 10.1016/j.ejogrb.2015.11.018.

12. Elser DM, Wyman JF, McClish DK et al. The effect of bladder training, pelvic floor muscle training, or combination training on urodynamic parameters in women with urinary incontinence. Continence program for women research group. Neurourol Urodyn 1999; 18 (5): 427–436. doi: 10.1002/ (sici) 1520-6777 (1999) 15: 5<427:: aid-nau3>3.0. co; 2-0.

13. Olivera CK, Meriwether K, El-Nashar S et al. Nonantimuscarinic treatment for overactive bladder: a systematic review. Am J Obstet Gynecol 2016; 215 (1): 34–57. doi: 10.1016/j.ajog. 2016.01.156.

14. Bernstein IT. The pelvic floor muscles: muscle thickness in healthy and urinary-incontinent women measured by perineal ultrasonography with reference to the effect of pelvic floor training. Estrogen receptor studies. Neurourol Urodyn 1997; 16 (4): 237–275. doi: 10.1002/ (sici) 1520-6777 (1997) 16: 4<237:: aid-nau2>3.0.co; 2-f.

15. Scott K, Dmochowski RR, Padmanabhan P. Delivery methods for drugs used in the treatment of overactive bladder. Expert Opin Drug Deliv 2016; 13 (3): 361–371. doi: 10.1517/17 425247.2016.1130033.

16. Visco AG, Fraser MO, Newgreen D et al. What is the role of combination drug therapy in the treatment of overactive bladder? ICI-RS 2014. Neurourol Urodynam 2016; 35 (2): 288–292. doi: 10.1002/nau.22795.

17. Kelleher C, Hakimi Z, Zur R. Efficacy and tolerability of mirabegron compared with antimuscarinic monotherapy or combination therapies for overactive bladder: a systematic review and network meta-analysis. Eur Urol 2018; 74 (3): 324–333. doi: 10.1016/j.eururo.2018.03. 020.

18. Pratt TS, Suskind AM. Management of overactive bladder in older women. Curr Urol Rep 2019; 19 (11): 92. doi: 10.1007/s11934- 018-0845-5.

19. Paśko P, Rodacki T, Domagała-Rodacka R et al. A short review of drug-food interactions of medicines treating overactive bladder syndrome. Int J Clin Pharm 2016; 38 (6): 1350–1356. doi: 10.1007/s11096-016-03 83-5.

20. Cody JD, Jacobs ML, Richardson K et al. Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev 2012; 10 (10): CD001405. doi: 10.1002/14651858.CD001405.pub3.

21. Rovner ES, Raymond K, Andruczyk E et al. Low-dose desmopressin and tolterodine combination therapy for treating nocturia in women with overactive bladder: a double-blind, randomized, controlled study. Low Urin Tract Symptoms 2018; 10 (3): 221–230. doi: 10.1111/luts.12169.

22. de Wall LL, Heesakkers JP. Effectiveness of percutaneous tibial nerve stimulation in the treatment of overactive bladder syndrome. Res Rep Urol 2017; 9: 145–157. doi: 10.2147/RRU.S124981.

23. Siddiqui NY, Wu JM, Amundsen CL. Efficacy and adverse events of sacral nerve stimulation for overactive bladder: a systematic review. Neurourol Urodyn 2010; 29 (Suppl 1): S18–S23. doi: 10.1002/nau.20786.

24. Ramírez-García I, Blanco-Ratto L, Kauffmann S et al. Efficacy of transcutaneous sti5mulation of the posterior tibial nerve compared to percutaneous stimulation in idiopathic overactive bladder syndrome: randomized control trial. Neurourol Urodyn 2019; 38 (1): 261–268. doi: 10.1002/nau.23843.

25. Rai BP, Cody JD, Alhasso A et al. Anticholinergic drugs versus non-drug active therapies for non-neurogenic overactive bladder syndrome in adults. Cochrane Database Syst Rev 2012; 12 (12): CD003193. doi: 10.1002/14651858.CD003193.pub4.

26. Vecchioli-Scaldazza C, Morosetti C. Effectiveness and durability of solifenacin versus percutaneous tibial nerve stimulation versus their combination for the treatment of women with overactive bladder syndrome: a randomized controlled study with a follow-up of ten months. Int Braz J Urol 2018; 44 (1): 102–108. doi: 10.1590/S1677-5538.IBJU.2016. 0611.

27. Rostaminia G, Chang C, Pincus JB et al. Predictors of successful percutaneous tibial nerve stimulation (PTNS) in the treatment of overactive bladder syndrome. Int Urogynecol J 2019; 30 (10): 1735–1745. doi: 10.1007/s00192-018-38 34-9.

28. Scaldazza CV, Morosetti C, Giampieretti R et al. Percutaneous tibial nerve stimulation versus electrical stimulation with pelvic floor muscle training for overactive bladder syndrome in women: results of a randomized controlled study. Int Braz J Urol 2017; 43 (1): 121–126. doi: 10.1590/S1677-5538.IBJU.2015.07 19.

29. Ramos HL, Torres Castellanos L, Esparza IP et al. Management of overactive bladder with onabotulinumtoxin A: systematic review and meta-analysis. Urology 2017; 100: 53–58. doi: 10.1016/j.urology.2016.10.026.

30. de Boer TA, Salvatore S, Cardozo L et al. Pelvic organ prolapse and overactive bladder. Neurourol Urodyn 2010; 29 (1): 30–39. doi: 10.1002/nau.20858.

31. Liedl B, Goeschen K, Yassouridis A et al. Cure of underactive and overactive bladder symptoms in women by 1,671 apical sling operations gives fresh insights into pathogenesis and need for definition change. Urol Int 2019; 103 (2): 228–234. doi: 10.1159/000500 329.

32. Tomoe H. Improvement of overactive bladder symptoms after tension-free vaginal mesh operation in women with pelvic organ prolapse: correlation with preoperative urodynamic findings. Int J Urol 2015; 22 (6): 577–558. doi: 10.1111/iju.12744.

33. Aslam MZ, Agarwal M. Detrusor myectomy: long-term functional outcomes. Int J Urol 2012; 19 (12): 1099–1102. doi: 10.1111/j.14 42-2042.2012.03111.x.

34. Holm J, Struckmann JR, Frimodt-Møller C. Augmentation ileo-cystoplasty in women with disabling urge incontinence. Ugeskr Laeger 1995; 157 (11): 1528–1530.

35. SÚKL. Betmiga. 2021 [online]. Dostupné z: https: //www.sukl.cz/modules/medication/detail.php?code=0194799&tab=prices.

36. Martan A, Mašata J, Krnut J et al. Persistence in the treatment of overactive bladder syndrome (OAB) with mirabegron in a multicenter clinical study. Eur J Obstet Gynecol Reprod Biol 2017; 210: 247–250. doi: 10.1016/ j.ejogrb.2016.12.030.

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