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Considerations in Male Overactive Bladder

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Contemporary Pharmacotherapy of Overactive Bladder

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Abstract

Overactive bladder (OAB) and storage lower urinary tract symptoms (LUTS) are highly prevalent in men and may present alone, or in the setting of bladder outlet obstruction (BOO). If the symptoms are not highly bothersome, initial treatment may be conservative and focused on behavioral modification. In those men with predominantly voiding LUTS and/or evidence of BOO, treatment will be aimed at reducing bladder outlet resistance either pharmacologically or surgically. In those men with predominantly bothersome storage LUTS and low post-void residual urine volume, further treatment is aimed at increasing bladder capacity and reducing detrusor overactivity. This is initially accomplished with pharmaceutical agents, with surgical measures reserved for those with treatment failure or significant medication-related side effects. For those men with both bothersome storage and voiding LUTS, combination therapy has been shown to be both effective and safe. Despite deficits in our understanding of the pathophysiological connection between BOO and OAB, as well as often insufficient data to support a particular treatment regimen, the treatment options for LUTS are largely effective and safe. As with any condition, more conservative options should be attempted first, and further treatment can be tailored to the individual patient.

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Authors and Affiliations

  1. Department of Urology, LSU Health – Shreveport, Louisiana State University, Shreveport, LA, USA

    Alex Gomelsky & Emily F. Kelly

  2. LSU Health – Shreveport, Louisiana State University, Shreveport, LA, USA

    Rebecca Budish

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  1. Alex Gomelsky
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Correspondence to Alex Gomelsky .

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  1. Department of Urology, Medical University of South Carolina, Charleston, SC, USA

    Lindsey Cox

  2. Department of Urology, Medical University of South Carolina, Charleston, SC, USA

    Eric S. Rovner

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Gomelsky, A., Kelly, E.F., Budish, R. (2019). Considerations in Male Overactive Bladder. In: Cox, L., Rovner, E. (eds) Contemporary Pharmacotherapy of Overactive Bladder. Springer, Cham. https://doi.org/10.1007/978-3-319-97265-7_15

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