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Introduction: Overactive bladder syndrome (OAB) is very common. It has been shown that urge incontinence is more difficult for women than for men, sinse they have higher levels of stress, depression, and more pronounced sexual dysfunction., Material and Methods: The study included 47 patients aged 54.6+/-3.5 years with symptoms of OAB. The Overactive Bladder Symptom Score (OABSS) was used to assess the symptoms, while the sexual function of the patients was evaluated using the Female Sexual Dysfunction Index (FSFI). In addition, Mini Mental State Examination (MMSE) scale was used for assessing the cognitive function. In comparison group there were 22 women who were comparable in socio-demographic characteristics, but didnt have symptoms of OAB. The comparison between two groups was carried out using FSFI scale. Patients in the OAB group were prescribed trospium chloride (Spazmex) 15 mg b.i.d. for three months, after which the patients completed the OABSS, FSFI, and MMSE questionnaires again., Results: All patients with OAB reported sexual dysfunction, which was significantly more profound than in the control group. The FSFI scores were, respectively, 15.23+/-6.12 versus 22.46+/-5.47. The average assessment of the cognitive abilities of patients with OAB was 27.9+/-1.4, which indicates that their cognitive functions were completely intact. The mean score on the OABSS scale was 11.8+/-2.7, and 11 women (23.4%) had a mild OAB, and 36 (76.6%) had moderate severity of symptoms. After three months of therapy, the mean score on the OABSS scale decreased by half, to an average of 5.4+/-1.2 points; the overall score of the FSFI approached the level of healthy women (20.64 and 22.46, respectively). The repeated assessment of the mental status did not reveal any changes, since the mean score of MMSE was 27.8+/-1.3. No significant adverse events were noted in any case. None of the patients required dose adjustment of the drugs that they received for concomitant diseases., Conclusion: All women with OAB syndrome had decreased sexual function compared to healthy women of the same age and social status. A three-month course of trospium chloride (Spazmex), 30 mg daily, significantly improved both the parameters of urination and the sexual function, without having any adverse effect on their cognitive abilities. Moreover, there was no need to adjust the doses of drugs taken for concomitant diseases.

An overactive bladder (OAB) is a constellation of lower urinary tract symptoms, including urgency, increased frequency of urination during the day and/or night (nocturia), and, in some cases, urge incontinence. This syndrome can be caused by different conditions, and currently no universal pathogenetic treatment has been developed. In addition, there are virtually no Russian-language publications providing information on the neurophysiology and neuroanatomy of the lower urinary tract. At the same time, the importance of this topic can hardly be overestimated. Often, a patient with a neurogenic dysfunction of the lower urinary tract has different comorbidities, which requires to deeply understand the mechanisms of development of certain symptoms. Considering an absence of clear data about the peripheral bladder innervation, role of the structures of the central nervous system and importance of neurotransmitters, it is rather difficult to provide high-quality specialized care. However, in recent years, a lot of new facts and theories have been described in basic researches. This lecture is dedicated to the current data on the pathogenesis of OAB. The purpose of the lecture is to summarize the results of fundamental and clinical studies on the pathogenesis of OAB.