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Advancing the Management of OAB: A Therapeutic Update
Overactive bladder (OAB) is defined as urinary urgency with or without urge incontinence, usually with urinary frequency and nocturia, and occurs in the absence of infectious, neoplastic, or other pathology. The management of OAB includes behavior modification and the use of medication, alone or in combination with one another. Antimuscarinic agents remain the mainstay of therapy; however they do differ in their chemical structure and resultant side-effect and tolerability profiles. The use of the recently approved Sanctura XR (a quaternary amine) is associated with an efficacy profile that is significantly greater than placebo. Efficacy parameters include urinary frequency, the number of UI episodes per 24 hours, volume voided per void, and severity of urgency per void. Its unique chemical structure reduces the risk of drug-drug interactions since it is largely not metabolized via the liver. The side effect profile of the extended release formulation of trospium chloride, specifically the occurrence of dry mouth, has been shown to be less than that reported for other antimuscarinincs following a review of the published literature. The approval of a new, once-daily formulation of trospium chloride may also improve compliance rates among patients.
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