[First-line treatment for non-neurogenic overactive bladder].

The aim was to synthesize current knowledge on overactive bladder (OAB) first-line treatments.

A systematic literature review based on PubMed, Embase and Google Scholar was conducted in June 2020.

Behavioral treatments are based on bladder training and timed voiding using a bladder diary. Lifestyle modifications should be suggested. They include reduction of fluid intake, consumption of caffeine, sodas, weight loss, avoidance of acidic fruit juices and of spicy and acidic salty diet, alkalization of urine by diet and possibly, vitamin D supplementation. Pelvic floor muscle training is mainly based on manual techniques, electrostimulation and/or biofeedback. It has been shown to be effective in treating OAB. In menopausal women, local hormone therapy improves all OAB symptoms. Oral drugs include anticholinergics and beta-3-agonists. Their efficacy is quite similar and superior to placebo. In case of failure of monotherapy, they may be combined.

Apart from some lifestyle modifications, the efficacy of first-line treatments for OAB has been demonstrated by prospective controlled studies. They may be prescribed individually or in combination.

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2020 Nov [Epub]

X Gamé, V Phé

Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, université Paul-Sabatier, TSA50032, 31059 Toulouse, France. Electronic address: ., Service d'urologie, AP-HP, hôpital Pitié-Salpêtrière, Sorbonne université, Paris, France.

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