[Urinary incontinence caused by an overactive bladder].

Abstract

Overactive bladder syndrome (OAB) is characterized by urgency, usually associated with increased daytime frequency and nocturia, with or without urgency urinary incontinence. In France, its prevalence is estimated at 14%, with approximately one-third of patients presenting a "wet" form, i.e. with urinary leakage. Diagnosis relies on medical history, clinical examination, bladder diaries, symptom scores and, when needed, a pad test. Management should be individualized and starts with lifestyle and behavioral measures, possibly combined with pelvic floor muscle training, local estrogen therapy and transcutaneous tibial nerve stimulation when indicated. Pharmacological treatment includes anticholinergics and β3-agonists (mirabegron and vibegron), and refractory cases may benefit from intradetrusor botulinum toxin injections or sacral neuromodulation. Invasive surgical procedures remain exceptional and are reserved for severe cases, most often in patients with neurological disorders.