Aims: In this review we try to shed light on the following questions: How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP? Does the presence of OAB symptoms depend on the prolapsed compartment and/or stage of the prolapse? What is the possible pathophysiology of OAB in POP? Do OAB symptoms and DO change after conservative or surgical treatment of POP? Methods: We searched on Medline and Embase for relevant studies. We only included studies in which actual data about OAB symptoms were available. All data for prolapse surgery were without the results of concomitant stress urinary incontinence (SUI) surgery.Results: Community‐ and hospital‐based studies showed that the prevalence of OAB symptoms was greater in patients with POP than without POP. No evidence was found for a relationship between the compartment or stage of the prolapse and the presence of OAB symptoms. All treatments for POP (surgery, pessaries) resulted in an improvement in OAB symptoms. It is unclear what predicts whether OAB symptoms disappear or not. When there is concomitant DO and POP, following POP surgery DO disappear in a proportion of the patients. Bladder outlet obstruction is likely to be the most important mechanism by which POP induces OAB symptoms and DO signs. However, several other mechanisms might also play a role.Conclusions: There are strong indications that there is a causal relationship between OAB and POP. Neurourol. Urodynam. 29: 30–39, 2010.

Aims: To summarize current knowledge on the etiology, assessment, and management of urinary incontinence (UI) in frail older persons. “Frail” here indicates a person with a clinical phenotype combining impaired physical activity, mobility, muscle strength, cognition, nutrition, and endurance, associated with being homebound or in care institutions and a high risk of intercurrent disease, disability, and death.Methods: Revision of 3rd ICI report using systematic review covering years 2004–2008.Results: We focus on the etiologic, management, and treatment implications of the key concept that UI in frail persons constitutes a syndromic model with multiple interacting risk factors, including age‐related physiologic changes, comorbidity, and the common pathways between them. We present new findings with evidence summaries based on all previous data, and an evidence‐based algorithm for evaluation and management of UI in frail elderly. We also present new evidence and summarize the data on etiology and management of nocturia and urinary retention in frail elderly.Conclusions: Despite the overwhelming burden of UI among this population, there remains a continuing paucity of new clinical trials in frail elderly, limiting evidence for the effectiveness of the full range of UI therapy. Future research is needed on current UI treatments (especially models of care delivery, and pharmacologic and surgical therapies), novel management approaches, and the etiologic mechanisms and pathways of the syndromic model. Neurourol. Urodynam. 29: 165–178, 2010.

Drug therapy for overactive bladder (OAB) is associated with improvements in symptoms and quality of life, but the short‐ and long‐term adherence and persistence is suboptimal. In this review we outline methods of measuring, and factors affecting, adherence to pharmacotherapy in patients with OAB. Clinical practice suggests that adherence rates reported in clinical trials are much greater than in real practice. Factors affecting adherence include psychological and social variables that might alter patients’ perception of the benefits of taking medication, and the effect of comorbidity and polypharmacy. Whilst there is some evidence that lack of efficacy and side‐effects are contributory, these additional factors are also important.

CUA guideline on adult overactive bladder