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Am Fam Physician. 2023;108(2):130-131

Author disclosure: No relevant financial relationships.

Details for This Review Study Population:

Adults 18 years or older with a diagnosis of symptomatic overactive bladder or detrusor overactivity

Efficacy End Points: Condition-specific quality of life; patient perception of cure or improvement; mean number of urgency episodes per 24 hours; mean number of micturitions per 24 hours

Harm End Points: Adverse events, including dry mouth and urinary retention; withdrawal from the trial due to adverse events

BenefitsHarms
1 in 7 was helped (patient perception of cure or improvement)
1 fewer episode of urgency per 24 hours on average
1 in 6 had dry mouth
1 in 111 had urinary retention
1 in 76 withdrew due to adverse events

Narrative: Overactive bladder describes a clinical syndrome of urinary urgency with or without incontinence that may be related to spontaneous contraction of the detrusor smooth muscle. Overactive bladder causes bothersome symptoms in 29.8 million U.S. adults 40 years and older, with women being affected nearly twice as often as men.1 Common treatment for overactive bladder includes oral anticholinergics, which are thought to work by blocking the muscarinic M3 receptors of the bladder's smooth muscle, causing relaxation; similar receptors are found throughout the body. Common adverse events from oral anticholinergics include dry mouth, constipation, dyspepsia, abdominal pain, urinary retention, urinary tract infection, dry eyes, blurred vision, headache, and dizziness. The Cochrane review discussed here examines the benefits and harms of anticholinergic drugs compared with placebo for the treatment of overactive bladder.2

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This series is coordinated by Christopher W. Bunt, MD, AFP assistant medical editor, and the NNT Group.

A collection of Medicine by the Numbers published in AFP is available at https:// www.aafp.org/afp/mbtn.

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