Hyperactive bladder is the term for a sum of symptoms with different causes and its prevalence increases with age. The diagnostic process is very simple and it is based on case history with a focus of urgency (sudden and strong urge to urinate that is very difficult to suppress), the presence of incontinence or lack thereof, the frequency of micturition (more than 8 times per 24 hours) and repeated urination during night (nocturia).
The therapy is based on two main principles: the patient's active approach and prescribed pharmacotherapy. Anticholinergic drugs are main mode of treatment used for hyperactive bladder symptoms.
Efficacy is high but the side effects of anticholinergics (mainly dry mouth and constipation) are limiting factors their usage in long-term treatment. Vaginal oestrogen therapy is very often added to anticholinergics in postmenopausal women.
Positive effects on urogenital atrophy and urogenital tract sensitivity may lead to reduction of anticholinergic doses with preservation of efficacy and to improved compliance with the longterm treatment.