Managing Overactive Bladder Symptoms in a Palliative Care Setting

Background: The combined symptoms of urinary frequency, urgency, nocturia, and incontinence (overactive bladder) are common symptoms within an elderly population but are also seen in palliative care patients and are most often due to detrusor muscle overactivity. These symptoms can lead to a marked reduction in quality of life and pharmacological management is traditionally with anticholinergic drugs. These medications carry a high risk of side effects and are often poorly tolerated by palliative care patients. Other management approaches, however, such as the use of urisheaths may markedly improve quality of life without adding to symptom burden in patients nearing the end of life. Objectives: This article highlights two cases in palliative care where overactive bladder symptoms prove difficult to manage with anticholinergic drugs. Conclusions: The discussion will give an overview of treatment strategies to help aid the clinician in managing these difficult symptoms in patients with a terminal illness.