Question

Should I use anticholinergics to treat overactive bladder syndrome in adults?

Bottom Line

The use of anticholinergic drugs by men and women with overactive bladder syndrome results in statistically significant improvements in symptoms, and a modest improvement in quality of life ratings. On average, people taking anticholinergic medication for overactive bladder syndrome had about 5 less trips to the toilet and 4 less leakage episodes every week (NNT* 4-8). Caution is needed with the frail elderly who are more at risk of side effects. * NNT = number needed to treat to benefit one individual.

Caveat

It is not clear whether any benefits are sustained during long term treatment or after treatment stops. About 1 in 3 people taking the drugs reported a dry mouth but for most this was not sufficiently troublesome for them to stop treatment (NNH** 1-10).

Context

A person who voids more than 8 times in 24 hours is considered to have frequency. About 16 per cent of adults over 40 years old have symptoms of overactive bladder syndrome (urgency with frequency and/or urge incontinence).1