Overactive bladder symptoms in women: current concepts in patient management

The symptoms of overactive bladder (OAB) -- urinary urgency, frequency, and urge incontinence -- can cause siginificant lifestyle limitations. Social isolation, depression, employment difficulties, and relationship stress are common findings in patients with this condition. This article focuses on women with OAB who are seen in primary care. Occasionally, OAB (or detrusor overactivity) may be the result of neurological disease, metabolic disease, or urinary tract abnormalities. Primary care practitioners can play a key role in identifying affected individuals by including a focused question in every annual patient physical assessment. Investigation and treatment can then be initiated, beginning with behavioral modification strategies (such as modifying fluid intake) and adding antimuscarinic pharmacotherapy or possibly local estrogen therapy where needed. Only patients with certain concurrent diseases or those who are refractory to conventional management will require referral to a specialist.