State-of-the-art office evaluation and treatment options for symptoms of an overactive bladder

Abstract

The defining symptom of an overactive bladder (OAB) is urgency. OAB is a condition that 16% of Americans suffer from. There is a direct cost of more than $6 billion annually. Symptoms of an OAB affect both men and women in almost equal percentages, especially with advancing age. Most medical offices have the ability to offer state-of-the-art evaluations in a painless and efficient manner. There have been significant breakthroughs in minimally invasive technology that provide practitioners with specific data to help customize treatment for each individual patient. Over the past 15 years, there have been multiple advances in treatment options for OAB. We have seen several new medications that are more selectively geared toward the urinary bladder. There have also been advances in surgical and nonsurgical modalities. We see that most of these advances benefit patients who have refractory symptoms. The greatest advances have occurred in the area of neuromodulation. We now are able to improve our patients' quality of life, even in the most extreme cases. Many other symptoms are seen in patients with an OAB. Using state-of-the-art technologies, we can quickly evaluate most of these patients in the office setting. The medical history and physical remain the mainstays of evaluating these patients. As osteopathic physicians, we have the unique ability to focus our evaluations by fully understanding the neurologic and muscular physiology for this condition. The osteopathic physician has an advantage when applying a complete musculoskeletal examination as part of the physical. We can potentially uncover other contributing conditions that are perhaps easier to treat. As our research and the osteopathic profession expand, perhaps we can formulate newer treatment opportunities using manipulative medicine. This article focuses on the current and practical treatments available to our patients.