The bottom line: Non-neurogenic OAB usually presents with urinary urgency, frequency and nocturia with or without incontinence. Initial work up includes detailed history and physical exam and urinalysis. Treatment options are based on weighing benefit versus risk. Some patients and their caregivers may opt for no treatment. Behavioral therapy should be offered to all patients since it has essentially no adverse effects. Antimuscarinics are the only FDA approved medications. All oral antimuscarinics are equally effective, though they vary in side-effects. Close follow up is crucial to assess side effects and efficacy.
Reference
• Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: American Urological Association/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Guideline (J. Urol. 2012 Dec;188:2455-63 [doi:10.1016/j.juro.2012.09.079]).
Dr. Skolnik is an associate director of the family medicine residency program at Abington (Pa.) Memorial Hospital. Dr. Tien is a third-year resident in the Family Medicine Residency Program at Abington Memorial Hospital, and a new mom to her wonderful son, Andrew.