Treatments for overactive bladder (OAB) range from fluid management and behavioral changes to pharmacological options like anticholinergics and newer alternatives such as beta-3 agonists (mirabegron) and neuromodulation techniques. However, in older adults, the cumulative anticholinergic load from medications can lead to cognitive and physical impairments.
Recent advances in OAB management include the development of newer treatments like vibegron, a selective beta-3 agonist with fewer drug interaction risks, and the increasing use of botulinum toxin and neuromodulation devices. Implantable devices for posterior tibial nerve stimulation and sacral neuromodulation (SNM) offer promising long-term symptom relief, with newer rechargeable SNM devices addressing concerns about battery life. Additionally, innovative techniques like selective bladder denervation and laser therapy are being explored, though further research is required before they become mainstream treatments for OAB.
Reference: Araklitis G, Baines G, da Silva AS, Robinson D, Cardozo L. Recent advances in managing overactive bladder. F1000Res. 2020;9:F1000 Faculty Rev-1125. doi: 10.12688/f1000research.26607.1.