Revisão Acesso aberto Produção Nacional Revisado por pares

Overactive bladder – 18 years – Part II

2016; Sociedade Brasileira de Urologia; Volume: 42; Issue: 2 Linguagem: Inglês

10.1590/s1677-5538.ibju.2015.0367

ISSN

1677-6119

Autores

José Carlos Truzzi, Cristiano Mendes Gomes, Carlos Alberto Bezerra, Mauricio Plata, Jose Campos, Gustavo Garrido, Fernando G. Almeida, Márcio Augusto Averbeck, Alexandre Fornari, Aníbal Salazar, Arturo Dell’Oro, Caio Cintra, Carlos Alberto Ricetto Sacomani, Juan Pablo Tapia, Eduardo Alonso Serrano Brambila, Emilio Miguel Longo, Flavio Trigo Rocha, Francisco Ângelo Coutinho, G. Favre, José Antonio García, Juan Carlos Castaño, Miguel Reyes, Rodrigo Eugenio Leyton, Rúiter Silva Ferreira, Sergio López Durán, Vanda López, Ricardo Reges,

Tópico(s)

Urological Disorders and Treatments

Resumo

Traditionally, the treatment of overactive bladder syndrome has been based on the use of oral medications with the purpose of reestablishing the detrusor stability. The recent better understanding of the urothelial physiology fostered conceptual changes, and the oral anticholinergics – pillars of the overactive bladder pharmacotherapy – started to be not only recognized for their properties of inhibiting the detrusor contractile activity, but also their action on the bladder afference, and therefore, on the reduction of the symptoms that constitute the syndrome. Beta-adrenergic agonists, which were recently added to the list of drugs for the treatment of overactive bladder, still wait for a definitive positioning – as either a second-line therapy or an adjuvant to oral anticholinergics. Conservative treatment failure, whether due to unsatisfactory results or the presence of adverse side effects, define it as refractory overactive bladder. In this context, the intravesical injection of botulinum toxin type A emerged as an effective option for the existing gap between the primary measures and more complex procedures such as bladder augmentation. Sacral neuromodulation, described three decades ago, had its indication reinforced in this overactive bladder era. Likewise, the electric stimulation of the tibial nerve is now a minimally invasive alternative to treat those with refractory overactive bladder. The results of the systematic literature review on the oral pharmacological treatment and the treatment of refractory overactive bladder gave rise to this second part of the review article Overactive Bladder – 18 years, prepared during the 1st Latin-American Consultation on Overactive Bladder.

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