Management of Overactive Bladder in the Face of High Grade Prolapse

Abstract

Patients with pelvic organ prolapse (POP) may present with a large combination of symptoms including overactive bladder (OAB) symptoms such as urgency, frequency, and urgency incontinence. The explanation as to why these symptoms are more prevalent in POP patients is not clearly understood, but there seems to be an overall agreement that prolapse-induced bladder outlet obstruction (BOO) may trigger bladder changes resulting in OAB symptoms. Presuming this to be true, many of the studies managing OAB in POP patients have focused on the surgical management of prolapse and its aftermath, which in many of the patients leads to improvement of OAB symptoms. This review presents the most recent studies and evidence looking at management of OAB in the face of POP and seeks to evaluate if there is any association between prolapse severity and OAB symptoms.

Keywords: Antimuscarinics; Bladder outlet obstruction; Overactive bladder; Pelvic organ prolapse; Urge incontinence; Urgency.