BMJ  2003;327:291 (2 August), doi:10.1136/bmj.327.7409.291

Letter

Behavioural approaches are helpful in overactive bladder

The first 150 words of the full text of this article appear below.

EDITOR—Herbison et al made a plea for a more pragmatic approach to evaluating patients with an overactive bladder syndrome.¹ A strong criticism of the work performed to date relates to the use of placebo as a control. They argue for the use of a behavioural approach such as bladder retraining as a comparator. This seems logical given that behavioural approaches are offered to most people with lower urinary tract symptoms (many of which will have overactive bladders) as a first line of treatment. Behavioural approaches might prove more effective for longer and lack the harms associated with pharmacotherapy.

We would not stop at bladder drill as one of the potential interventions.² It could be that fluid scheduling, caffeine restriction, pelvic floor exercises, and the optimised management of comorbid conditions could all have a place in the management of the overactive bladder syndrome.^{3 4} In this respect it is interesting . . . [Full text of this article]

Department of Medical Oncology, St Bartholomew's Hospital, London E1A 7BE MrTMLane@aol.com

Clinical Effectiveness Unit, Royal College of Surgeons, London WC2A 3PE

Institute of Urology, University College London, London W1P 7PN

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