Treatment of Overactive Bladder — What is Best? Presented by (insert name of presenter here)

Treatment of Overactive Treatment of Overactive Bladder — What is Best?Bladder — What is Best?Treatment of Overactive Treatment of Overactive Bladder — What is Best?Bladder — What is Best?Presented by (insert name of presenter here)

Who Manages Patients with Who Manages Patients with Overactive Bladder ?Overactive Bladder ?

Who Manages Patients with Who Manages Patients with Overactive Bladder ?Overactive Bladder ?

• General practitioners (GPs)

• Nurses/ continence advisors

• Geriatricians

• Urologists

• Gynaecologists

• Others E.g. paediatricians, neurologists, physiotherapists and psychologists

Treatment Options — Treatment Options — Overactive BladderOveractive Bladder

Treatment Options — Treatment Options — Overactive BladderOveractive Bladder

• Drug therapy

• Bladder training techniques

• Intermittent self-catheterization

• Incontinence pads and protective equipment

• Surgery

Drug TherapyDrug TherapyDrug TherapyDrug Therapy

Drug therapyDrug therapy is becoming increasingly important and is currently the mainstay in the treatment for overactive bladderoveractive bladder.


MedicationsMedications used to treat overactive bladder can be highly effective in providing relief of symptoms.


However, nearly all of the older drugs produce some unwanted side-effectsside-effects, which limits their use in some patients.

Drugs Used to Treat Drugs Used to Treat Bladder Control ProblemsBladder Control Problems

Drugs Used to Treat Drugs Used to Treat Bladder Control ProblemsBladder Control Problems

• Oxybutynin

• Propantheline

• Imipramine

OxybutyninOxybutyninOxybutyninOxybutyninAdvantages Effective

Disadvantages Frequently causes dry mouth,

dry throat, lingering bad taste Poor long-term

tolerability/ compliance The drug produces effects not

only in the bladder but otherorgans as well

Requires frequent doseadjustments

Advantages Disadvantages Effective Requires doseadjustment

Little documentation ofclinical efficacy inoveractive bladder

The drug produceseffects not only in thebladder but in otherorgans as well

PropanthelinePropanthelinePropanthelinePropantheline

ImipramineImipramineImipramineImipramine

Advantages Disadvantages Effective for

treating night-timeincontinence inchildren

Side-effect profile limitsits usefulness in thetreatment of urinaryincontinence

The drug produceseffects not only in thebladder but in otherorgans as well

Typical Side Effects Caused Typical Side Effects Caused By Older Drug TherapiesBy Older Drug Therapies

Typical Side Effects Caused Typical Side Effects Caused By Older Drug TherapiesBy Older Drug Therapies

• Dry mouth

• Constipation

• Blurred vision

• Drowsiness

DetrusitolDetrusitol (Tolterodine) (Tolterodine)DetrusitolDetrusitol (Tolterodine) (Tolterodine)

• DetrusitolDetrusitol is a new drug that has the potential to help a wide range of patients with symptoms of an overactive bladder: i.e. urgency, frequency and urge incontinence


DetrusitolDetrusitol will help:

• men and women suffering from symptoms of an overactive bladderoveractive bladder

• women suffering from mixed incontinencemixed incontinence

• patients with overactive bladder due to: strokes, spinal injury, dementia


Summary Summary

• The first first drug that is specifically developed to treat patients with an overactive bladderoveractive bladder

• Provides effectiveeffective bladder control


Summary (cont’d)Summary (cont’d)

• Well toleratedWell tolerated

• ConvenientConvenient to take — one tablet twice a day

DetrusitolDetrusitolDetrusitolDetrusitol

Correct use of Correct use of DetrusitolDetrusitol (Tolterodine)(Tolterodine)

Correct use of Correct use of DetrusitolDetrusitol (Tolterodine)(Tolterodine)

• ReducesReduces the number of timesnumber of times you urinate each day

• IncreasesIncreases the volume of urinevolume of urine in your bladder

• If you have urge incontinence, it decreasesdecreases the number of times you suffer from incontinenceincontinence each day.

Bladder Training:Bladder Training:Frequency/Volume RegulationFrequency/Volume Regulation

Bladder Training:Bladder Training:Frequency/Volume RegulationFrequency/Volume Regulation

Bladder TrainingBladder TrainingBladder TrainingBladder Training

Aims:Aims:

• Helps patients regain control of their bladder by teaching them to resist the urge to pass urine

• Helps to increase bladder capacity and reduce the number of episodes of incontinence.

Bladder Training (cont’d)Bladder Training (cont’d)Bladder Training (cont’d)Bladder Training (cont’d)

Bladder trainingBladder training is effective but requires a high degree of motivationmotivation and commitmentcommitment from patients.

Incontinence Pads and Incontinence Pads and Protective EquipmentProtective Equipment


Absorbent pads

Dribble pouch

Reusable underpants designed to carry disposable absorbent pads

All-in-one briefs

Chair and bed pads



IncontinenceIncontinence padspads and protective protective equipmentequipment can be convenient, simple and effective to use.



• Frequent changing required

• Expensive

• Cumbersome

• Embarrassment

• Hygiene problems



Consequently, use of these products should be regarded as supplementary supplementary to other treatments and not as a first-line treatment for urinary incontinence.

SurgerySurgerySurgerySurgery

In some patients, surgerysurgery is only considered when all of the available measures, such as bladder training or drugs, have failedfailed.

SurgerySurgerySurgerySurgery

Example:

CystoplastyCystoplasty — a procedure in which a portion of the bowel is attached to the bladder to increase its capacity

Increasing Bladder CapacityIncreasing Bladder CapacityIncreasing Bladder CapacityIncreasing Bladder Capacity

No. of times of urination

Leakage episodes

Urgency sensations

Bladder capacity

Treatment of Overactive Bladder — What is Best? Presented by (insert name of presenter here)

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