Overactive bladder and stress incontinence – the major urogynaecological cause of reduced quality of life in women

Author: Slavko Orešković
Abstract:

Overactive bladder (OAB) is a clinical diagnosis based on the presence of urgency that requires exclusion of other conditions with similar symptoms, such as urinary tract infections or malignant processes in the pelvis. It is a frequent disorder that significantly reduces the quality of life of patients. The first line of treatment is conservative, such as behavioural therapy and use of antimuscarinic agents. It is necessary to distinguish between the overactive bladder and overactive detrusor on the basis of urodynamic findings. The incidence in the general female population is about 13-17% and increases with age. In women younger than 35 years, the prevalence of overactive bladder is up to 5%. In women aged over 65, the prevalence is 20-30%. It is known that nearly 25-30% of older women develop stress urinary incontinence. Stress urinary incontinence results from inborn or acquired pelvic organ support impairment, with the loss of anatomic support to vesicourethral segment. The diagnosis of pelvic organ prolapse and urinary incontinence is based on patient medical history, gynaecologic examination, clinical testing, cystometry, cystoscopy and urodynamic testing. Urinary incontinence can be treated both surgically and conservatively. Treatment success depends on a diagnostic procedure and properly chosen treatment method (surgical or conservative). The use of contemporary diagnostic and treatment procedures yields optimal therapeutic effects and helps maintain patient’s quality of life. 

Key words:
muscarinic antagonists; surgical procedures, operative; urinary bladder, overactive; urinary incontinence, stress