The review presents data on the epidemiology, clinical course and modern methods to the treatment of overactive bladder. It also describes the pharmacological bases of anticholinergic drug use, which are first-line in the treatment of this disease. The pharmacological and clinical aspects of the new M-holinoblocker, fesoterodine, are considered. The drug belongs to the competitive blockers of M2-and M3-cholinergic receptors. The conducted studies have shown the high clinical efficacy of fesoterodine. Due to the low lipophilicity and large molecular weight, the drug’s ability to penetrate the blood-brain barrier is minimal, which causes a low frequency of adverse events from the central nervous system. The pharmacokinetic and pharmacodynamic properties of fesoterodine allow it to be prescribed to "vulnerable" groups of patients — the elderly, patients with CNS diseases and cognitive disorders. According to the FORTA system, fesoterodine is the only antimuscarinic drug classified in category B. The results of a multiple-criteria decision-making showed a favorable benefit-risk profile of fesoterodine, prescribed according to a flexible dosage regimen of 4 mg and 8 mg. Important benefits of fesoterodine are the convenience of intake, the possibility of dose titration, as well as the ratio of treatment costs and its efficacy. The practical issues of using fesoterodine in various clinical cases are considered. KEYWORDS: overactive bladder, anticholinergic therapy, fesoterodine, multiple-criteria decision-making, FORTA classification. FOR CITATION: Kuzmin I.V., Kuzmina S.V. Anticholinergic therapy of an overactive bladder: clinical practice aspects. Russian Medical Inquiry. 2021;5(5):273–279 (in Russ.). DOI: 10.32364/2587-6821-2021-5-5-273-279.

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37 patients with multiple sclerosis who had complaints of urination disfunction have been investigated according to Poser criteria. On the basis of clinical and urometric studies (urofluometry) three main disfunctions of urinary bladder were determined. According to the type of urinary tract disfunctions a combination of medicinal preparations had been used. In a month patients of all the three groups had a significant improvement. In patients of the 1-st group urination frequency decreased by 35%, of the 2nd group by 34% and the quantity of residual urine reduced by 48%. In patients of the 3rd group quantity of residual urine came close to a norm, being decreased by 55%.