Newer pharmacologic options in management of overactive bladder syndrome

Urinary incontinence is an under-reported epidemic that currently affects an estimated 13 million people in the United States, of whom about 11 million are women, according to the National Institute of Diabetes and Digestive and Kidney Diseases (Publication No. 02-4132). Because many patients are unaware of curative options and perceive it to be an inevitable outcome of advancing age, they fail to report their symptoms and increase their risk of developing associated co-morbid disease. Failure to diagnose and treat this condition increases financial burdens on individuals, their families and health care organizations. Pharmacologic therapy of urge incontinence previously had limited treatment success because efficacious drugs were poorly tolerated, resulting in low patient compliance. Tolerance and effectiveness continue to be improved due to innovative new drugs and alternative delivery systems. The goal of this review is to update the clinician on the efficacy and the tolerability of established and investigational pharmacologic modalities of therapy.