Management of Overactive Bladder in Older Women

Abstract

Purpose of review: This review will highlight our current understanding of age-related changes in bladder function and propose important clinical considerations in the management of overactive bladder (OAB) specific to older women.

Recent findings: Frailty, functional and cognitive impairment, multimorbidity, polypharmacy, estrogen deficiency, and remaining life expectancy are important clinical factors to consider and may impact OAB symptom management in older women. Third-line therapies, particularly PTNS, may be preferable over second-line therapy in some cases. Due to the complexity within this population, the standard treatment algorithms may not be applicable, thus a broader, more holistic focus is recommended when managing OAB in older women.

Keywords: Botox; Elderly; Frailty; Geriatric syndromes; Pharmacotherapy; Sacral neuromodulation.

Figures

Figure 1.

Neurologic, anatomic and biochemical alterations associated with OAB in older women

Figure 2.

Special Considerations In Older Women with Overactive Bladder