2 UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE Denition Overactive bladder (OAB) is dened by the International Continence Society (ICS) as a syndrome of urinary urgency with or without urgency incontinence, usually accompanied by increased frequency more than eight micturitions/24 hours and nocturia. The diagnosis of OAB is only applicable in the absence of other conditions which could be causing the symptoms. These include urinary tract infections, bladder stones, interstitial cystitis or metabolic disease such as diabetes mellitus. Symptoms Denitions of overactive bladder symptoms Impact on Quality of Life OAB appears to have a signicant impact on quality of life (QOL) and affects activities of daily living, mental health and sexual function. However, there appears to be a reluctance on the part of many patients to seek help due to ignorance about effective treatments that are available. The EpiLUTS study showed that the motivation to seek medical help is associated with the number of symptoms, how bothersome the symptoms were and the patient's age. Older patients are more likely to seek help. Incidence Overactive bladder is a common chronic condition occurring in both men and women. Approximately 17% of the adult population is affected, with the prevalence increasing with age. Diagnosis In South Africa, urologists generally perform a patient history, targeted examination, urine dipstix/urine MCS and ultrasound of the abdomen as standard of care. UDS/owmetry and cystoscopy may be needed in specic cases as part of the evaluation for LUTS and OAB. Efficacy and safety of propiverine in patients with overactive bladder and neurogenic detrusor overactivity This article is a summary of the article by Saygisever-Faikoglu K, Faikoglu G, Ozcan FO, et al. Efcacy and safety of propiverine in patients with overactive bladder and neurogenic detrusor overactivity. Pharm Pharmacol Int J. 2022;10(2):51-58 and an article by Mutambirwa S, Overactive Bladder in Men. Published in a previous edition of this publication. Symptom Urinary urgency Urgency incontinence Increased frequency Nocturia Description A sudden and compelling urge to urinate that is difcult to postpone Involuntary urinary incontinence accompanied by urgency or occurring immediately after urgency Frequent urination during the day reported by patients The need to wake up one or more times during the night to urinate Age >60 years >75 years Incidence in men 19.1% 42% Incidence in women 18.3% 31%
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