REVIEW ARTICLE Current and future trends in the management of overactive bladder Adrian Wagg & Amitabha Majumdar & Philip Toozs-Hobson & Anand K. Patel & Christopher R. Chapple & Simon Hill Received: 26 June 2006 / Accepted: 14 August 2006 / Published online: 24 October 2006 # International Urogynecology Journal 2006 Abstract Urinary incontinence is a common problem which increases in prevalence in association with advancing age and has a significant adverse effect upon well-being and quality of life. It is not the “benign” condition that many take it for. Overactive bladder (frequency–urgency syndrome) is the commonest bladder problem in late life, affecting up to 41% of over-75-year-old individuals, and the elderly experience more severe disease. This small series should provide the reader with a comprehensive overview of the current thinking in the assessment and management of patients with overactive bladder syndrome, explores the history of the condition and current approaches to its medical and surgical management and explores where management may change in more complex populations. The current state and future developments in pharmacolog- ical therapy are also outlined. Keywords Detrusor overactivity . Overactive bladder syndrome . Urinary incontinence Introduction Adrian Wagg Urinary incontinence is a common problem which increases in prevalence in association with advancing age [1] and has a significant adverse effect upon well-being and quality of life [2]. It is not the “benign” condition that many take it for, there being an increase in skin infections [3], depression [4], sleep disturbance [5] and falls and fractures [6] associated with this troublesome condition. Overactive bladder (frequency–urgency syndrome) is the most common bladder problem in late life, affecting up to 41% of men and 31% of women over 75 [7], and the Int Urogynecol J (2007) 18:81–94 DOI 10.1007/s00192-006-0229-0 The development of this article was supported by an educational grant from UCB Pharma. A. Wagg University College Hospital, 25 Grafton Way, NW1 OPE London, UK e-mail: a.wagg@ucl.ac.uk P. Toozs-Hobson Birmingham Women’ s Hospital, Edgbaston Park Road, B15 2TG Birmingham, UK e-mail: philip.toozs-hobson@bwhct.nhs.uk A. Majumdar (*) : P. Toozs-Hobson Birmingham Women’ s Hospital, Metchley Park Road, B15 2TG Birmingham, UK e-mail: amitabhamajumdar@hotmail.com A. K. Patel Urology Research Department, Royal Hallamshire Hospital, Glossop Road, S10 2JF Sheffield, UK e-mail: anandkpatel@hotmail.com C. R. Chapple Royal Hallamshire Hospital, Glossop Road, S10 2JF Sheffield, UK e-mail: c.r.chapple@sheffield.ac.uk S. Hill Queen’ s Park Hospital, Haslingden Road, BB2 3HH Blackburn, UK e-mail: simon.hill@mail.bhrv.nwest.nhs.uk