Management of Overactive Bladder After Treatment of Bladder Outlet Obstruction

Purpose of Review: To discuss the epidemiology and pathophysiology of overactive bladder (OAB) after bladder outlet surgery (BOS), review the prognostic factors associated with persistent OAB, and present evaluation and management strategies. Recent Findings: A randomized trial of preoperative urodynamics in male lower urinary tract symptoms is underway; however, high-level evidence for management of persistent OAB after BOS is lacking. Summary: Identification of prognostic factors for persistent OAB symptoms is important for counseling patients before BOS; however, the data guiding such counseling are limited. In general, patients who are older, have lower bladder capacity, and higher amplitude and earlier detrusor overactivity are more likely to have persistent symptoms. After BOS, men may be less likely than women to respond favorably to advanced therapies for OAB than women and should be appropriately counseled.