Syndrome clinique d’hyperactivité vésicale non neurologique et pathologie pelvi-périnéale de la femme

Abstract

The aim was to synthesize current knowledge on overactive bladder (OAB) and female pelvic-perineal diseases. A systematic literature review based on PubMed, Embase and Google Scholar was conducted in April 2020. Women with pelvic organ prolapse very often have OAB. Prolapse surgery should be considered if the prolapse is symptomatic and never be indicated in case of overactive bladder symptoms solely. In case of symptomatic prolapse and OAB, pessary and surgical treatments are effective on both pathologies up to 71% of the cases. OAB may occur in parallel or as part of a menopausal genitourinary syndrome. In the latter case, only local estrogen therapy is effective. OAB may occur alongside stress urinary incontinence (SUI) or be integrated into mixed urinary incontinence. The initial treatment should be based on the most troublesome symptoms. In case of SUI, the outcome of surgical treatment on OAB remains uncertain. De novo, OAB follows prolapse or SUI surgery. It requires investigations to exclude urinary tract infection, bladder outlet obstruction or erosion. The treatment is the same as OAB. The clinician's challenge is to draw a balance between the OAB and a pelvic-perineal pathology in order to adapt the treatment.