Therapy goals
- Improvement of the continent situation
- Improvement of the quality of life
- Restoration of the function of the lower urinary tract (which is usually not possible or only partially possible).
- Protection of the upper urinary tract
Therapy recommendations
The following therapy recommendation depending on the particular disorder:
- For underlying increased bladder outlet resistance: alpha blockers.
- For overactive bladder or detrusor-related bladder emptying dysfunction: Anticholinergics or mirabegron (selective agonist of the human β-3-adrenoceptor (β-3-AR) localized in the detrusor).
- Detrusor overactivity (detrusor overactivity; result of damage to the nervous system from disease, accident, or congenital malformation): Anticholinergics (antimuscarinics) and mirabegron (see above).
- Detrusor-sphincter dyssynergia (DSD): anticholinergics (antimuscarinics) and mirabegron (see above).
- Hypocontractile detrusor: anticholinergics or alpha blockers.
- Nocturia: desmopressin (ADH); also anticholinergics if necessary.
- For recurrent urinary tract infections, antibiotics should always be used after antibiogram:
- Z. E. Low-dose oral antibiotic prophylaxis (nitrofurantoin 50 mg/d, trimethoprim 100 mg/d or cefalexin 250 mg/d).
- See also under “Further therapy“.