This guideline helps urologists identify overactive bladder (OAB) in men with lower urinary tract symptoms and establish treatment goals to improve quality of life. OAB, characterized by urinary urgency often with increased frequency and nocturia, is common among older men and is associated with other conditions like benign prostatic hyperplasia, diabetes, and heart failure. The presence of urgency is key for diagnosing OAB, and its prevalence increases with age, significantly impacting health-related quality of life.

The guideline emphasizes comprehensive assessments, including history, physical exams, and tests, to differentiate OAB from other bladder conditions like bladder outlet obstruction. Treatment for OAB should start with behavioral modifications, antimuscarinic medications, and potentially beta-3 adrenoceptor agonists. For men with both voiding and storage symptoms, a combination of antimuscarinics and alpha-blockers is recommended. Pharmacotherapy targeting the prostate often fails to relieve OAB symptoms, highlighting the need for a better understanding of underlying causes. Conservative treatments like pelvic floor muscle training and neuromodulation are also discussed as effective options, especially for refractory cases.

Reference: Wang CC, Liao C, Kuo H. Clinical guidelines for male lower urinary tract symptoms associated with non-neurogenic overactive bladder. Urol Sci. 2015;26. doi: 10.1016/j.urols.2014.12.003.