Detrusor Overactivity

Treatment of the overactive bladder involves the suppression or elimination of the abnormal bladder contractions causing this condition. Aims of treatment are the reduction of irritable bladder symptoms such as urinary frequency (by day and night), urgency and urge incontinence.

Treatment can be difficult with a 50% response from most treatments compared with a 30% response from the use of a placebo treatment.

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A: Detrusor Overactivity of Mild to Moderate Severity

Generally, some behavioural therapy under the guidance of a continence nurse or physiotherapist will be recommended as part of therapy. This will incorporate bladder training techniques, the principles of which are to:

  • Suppress Urgency
  • Increase Voided (urine passed) Volumes
  • Decrease Frequency
  • Decrease Urgency

B: Detrusor Overactivity of Moderate to Marked Severity

Generally, medication will be required. One of the groups of medications below might be chosen.

  • Propantheline (probanthine)
  • Oxybutynin (ditropan)
  • Oxytrol (ditropan in Patch Form)
  • Tolterodine (detrusitol)
  • Solifenacin (vesicare)
  • Mirabegron (betmiga)

Those medications generally appropriate for nighttime use only, are:

  • Amitryptyline (tryptanol)
  • Imipramine (tofranil)The following medication is appropriate for cases of bed-wetting:
    • Desmopressin (minirin)

All medications carry side effects, which should be discussed prior to commencing treatment.

Bladder

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