Pharmacotherapy of bladder dysfunction — past, present and future

Overactive bladder (OAB) encompasses a variety of conditions that may necessitate different therapeutic strategies. This diversity is evident in the wide range of medications used over the past five decades. Unfortunately, we have too few tools to identify individual conditions and even less informa...

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Main Author: Karl-Erik Andersson
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Continence Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2772974525000031
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author Karl-Erik Andersson
author_facet Karl-Erik Andersson
author_sort Karl-Erik Andersson
collection DOAJ
description Overactive bladder (OAB) encompasses a variety of conditions that may necessitate different therapeutic strategies. This diversity is evident in the wide range of medications used over the past five decades. Unfortunately, we have too few tools to identify individual conditions and even less information about which condition is best served by which treatment. Many of the drugs have been discontinued primarily due to an unfavorable balance between efficacy and adverse effects. As a result, current treatment guidelines primarily recommend antimuscarinics and β3-adrenoceptor agonists, with intravesical botulinum toxin injections as a second-line option. While these treatments have documented efficacy, their use is often limited by side effects, adherence challenges, and persistence issues. Personalized treatment approaches may help optimize the use of these medications. However, there is a need for improved therapies, and many promising future therapeutic alternatives can be discussed. However, there seem to be no drugs ready for immediate clinical introduction.
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spelling doaj-art-95fcbb4d2f6b4310a389fc9a8ffd002d2025-08-20T02:39:28ZengElsevierContinence Reports2772-97452025-06-011410008010.1016/j.contre.2025.100080Pharmacotherapy of bladder dysfunction — past, present and futureKarl-Erik Andersson0Correspondence to: Institute of Laboratory Medicine, Lund University, Lund, Sweden.; Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC, United States of America; Institute of Laboratory Medicine, Lund University, Lund, SwedenOveractive bladder (OAB) encompasses a variety of conditions that may necessitate different therapeutic strategies. This diversity is evident in the wide range of medications used over the past five decades. Unfortunately, we have too few tools to identify individual conditions and even less information about which condition is best served by which treatment. Many of the drugs have been discontinued primarily due to an unfavorable balance between efficacy and adverse effects. As a result, current treatment guidelines primarily recommend antimuscarinics and β3-adrenoceptor agonists, with intravesical botulinum toxin injections as a second-line option. While these treatments have documented efficacy, their use is often limited by side effects, adherence challenges, and persistence issues. Personalized treatment approaches may help optimize the use of these medications. However, there is a need for improved therapies, and many promising future therapeutic alternatives can be discussed. However, there seem to be no drugs ready for immediate clinical introduction.http://www.sciencedirect.com/science/article/pii/S2772974525000031Anticholinergicsβ3-adrenoceptor agonistsBotulinum toxinUrine storage dysfunctionOveractive bladder
spellingShingle Karl-Erik Andersson
Pharmacotherapy of bladder dysfunction — past, present and future
Continence Reports
Anticholinergics
β3-adrenoceptor agonists
Botulinum toxin
Urine storage dysfunction
Overactive bladder
title Pharmacotherapy of bladder dysfunction — past, present and future
title_full Pharmacotherapy of bladder dysfunction — past, present and future
title_fullStr Pharmacotherapy of bladder dysfunction — past, present and future
title_full_unstemmed Pharmacotherapy of bladder dysfunction — past, present and future
title_short Pharmacotherapy of bladder dysfunction — past, present and future
title_sort pharmacotherapy of bladder dysfunction past present and future
topic Anticholinergics
β3-adrenoceptor agonists
Botulinum toxin
Urine storage dysfunction
Overactive bladder
url http://www.sciencedirect.com/science/article/pii/S2772974525000031
work_keys_str_mv AT karlerikandersson pharmacotherapyofbladderdysfunctionpastpresentandfuture