Overactive bladder (OAB) impacts 10% to 16% of males and significantly impacts quality of life, productivity, and even results in economic burdens like absenteeism and early retirement; however, OAB in men is often misdiagnosed as bladder outflow obstruction (BOO), delaying appropriate treatment. Proper diagnosis in primary care is crucial, with a thorough history, physical examination, and specific tools like the OAB-V3 questionnaire helping to identify OAB symptoms. Additionally, screening for neurological causes and BOO is essential to rule out other conditions.

Pharmacological treatments for male OAB often begin with alpha-adrenergic blockers or 5-alpha-reductase inhibitors, especially when BOO coexists. Anticholinergics and beta-3 agonists are also effective, with mirabegron emerging as a well-tolerated option for first-line treatment. In cases of treatment failure or more complex conditions, specialists may utilize more advanced options like intravesical injections of onabotulinumtoxinA or sacral neuromodulation. Close follow-up and individualized treatment plans are key to managing OAB in men.

Reference: Millman AL, Cheung DC, Hackett C, Elterman D. Overactive bladder in men: a practical approach. Br J Gen Pract. 2018;68(671):298-299. doi: 10.3399/bjgp18X696593.