Overactive Bladder Syndrome in Women: Pathophysiology, Clinical Manifestations, and Therapeutic Challenges – A Systematic Review
Abstract
The bothersome and prevalent condition known as overactive bladder (OAB) in females is characterized by urgency, frequency, nocturia, and sometimes urge incontinence. It dramatically diminishes the quality of life by affecting social interaction, sleep patterns, and emotional well-being. This systematic review aims to extensively explore the pathophysiological mechanisms, risk factors, clinical manifestations, diagnostic strategies, and treatment challenges of OAB in females. A thorough search was carried out for studies published from 2013 until 2023 in the PubMed, Scopus, Web of Science, and Cochrane Library databases. The inclusion criteria embraced randomized controlled trials, cohort studies, case-control studies, and systematic reviews that concentrated on adult female populations. Studies where the male population or pediatric population was used were excluded; studies with unrelated urinary diseases were also excluded.
The results speak to a multifactorial pathogenesis of OAB involving urothelial dysfunction, neurogenic dysregulation, detrusor myogenic overactivity, chronic low-grade inflammation, and hormonal components-most importantly postmenopausal estrogen deficiency. It is precipitated by factors such as aging, parity, obesity, diabetes mellitus, and psychological stress. The clinical diagnostic tools comprise an accurate clinical history, some validated questionnaires, and bladder diaries apart from urodynamic studies. Behavioral plus lifestyle interventions; pharmaceutical treatment including beta-3 agonists and antimuscarinics; more advanced options such as neuromodulation and intravesical botulinum toxin injections are management techniques. Problems that remain even after therapies include inadequate relief of symptoms-drug side effects-high discontinuation rates-inconsistent patient response.
Although they need more clinical validation, emerging medicines such stem cell and gene-based interventions show promise.
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