OAB and Incontinence

Colin Goudelocke, MD, offers insight on 2 abstracts from the 2024 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting.

"Even the possibility of something really big and revolutionary can still be exciting even if we're in the early stages," says Colin Goudelocke, MD.

Colin Goudelocke, MD, describes an abstract presented at the 2024 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting.

“I think 1 size doesn't fit all. We can't make a blanket statement that 1 of those types of therapy is better for all patients than another,” says Suzette E. Sutherland, MD, MS, FPMRS.

In the intervention group, the HRQOL score changed by 23.9 points between baseline and week 13, from 18.4 to 29.5.

“I think the long and short of it is we know tibial nerve stimulation works, we're just trying to identify what's the best way by which we can deliver it conveniently and cost effectively to the patient,” says Suzette E. Sutherland, MD, MS, FPMRS.

Tepidimonas was notably associated with more severe urinary incontinence episodes, suggesting a potential marker for identifying individuals at risk for more severe symptoms.

According to Axonics, commercial sales of the R20 system in Europe are expected to begin in mid-April.

“Currently, in the area of tibial nerve stimulation, there are only 2 FDA approved options,” says Suzette E. Sutherland, MD, MS, FPMRS.

"We're very much looking forward to being able to clinically implement these algorithms, both on the OAB side and the antibiotic resistance side," says Glenn T. Werneburg, MD, PhD.

The therapy, known as Autologous Muscle Derived Cells for Urinary Sphincter Repair (iltamiocel), involves a medical procedure in which a participant’s own muscle cells are collected, processed, and then injected into the tissues of the urinary passage.

The odds of SUI recurrence following MUS were 17% to 24% among patients with childbirth vs 15% to 22% among patients without childbirth

"We're really enthusiastic on the overactive bladder end and on the antibiotic resistance end, but much more broadly, [AI is] set up to help us counsel our patients better and help us to improve outcomes for our patients as well," says Glenn T. Werneburg, MD, PhD.

Artus is an artificial urinary sphincter for the treatment of patients with moderate to severe urinary incontinence.

"Our outcomes showed 71% of patients achieved dry or near dry results in 6 to 12 weeks," says Nissrine Nakib, MD.

"What we found was that we were able to identify patients who responded vs didn't respond to the treatment with a high degree of accuracy," says Glenn T. Werneburg, MD, PhD.

"I would say that the biggest take-home is that many of our patients are using social media for their health care information, and this may influence their preferences [and] their decision-making," says Alexandra Tabakin, MD.

The post-market RESTORE trial plans to enroll 150 patients with urge urinary incontinence across 20 clinical trial sites in the US.

"Probably the most surprising finding was actually that there were several videos created by health care professionals that contain misinformation," says Alexandra Tabakin, MD.

Interim data from the study showed that at 6 months following implantation, 80% (4 of 5) of evaluable women with mixed UI experienced a complete resolution of incontinence episodes.

Overall, the patient met the study’s primary outcome measures of successful device activation and the rate of explants and revisions at 6 months.

"I think people don't understand how exhausting it is for people to manage these symptoms day in and day out," says Leslie Rickey, MD, MPH.

In this episode, experts review safety concerns, drug interactions, and common adverse effects (AEs) associated with overactive bladder (OAB) medications. They discuss the impact of AEs like constipation, hypertension, and dry mouth on patient quality of life, strategies for managing these effects, and circumstances warranting a change in treatment. The experts also examine recent clinical evidence linking anti-cholinergic treatments to an increased risk of dementia in older patients, discussing its implications for clinical practice and strategies for urologists to remain vigilant about such safety concerns.

Experts explore the clinical benefits and limitations of standard pharmacological options, like anti-muscarinic agents and beta-3 adrenergic agonists, and share their preferences and experiences in selecting and managing treatments for OAB, focusing on the effectiveness and patient-specific considerations in their clinical practice. In this episode, Dr. Kennelly, alongside Drs. Eilber and Benson, discusses the transition to second-line therapies for overactive bladder, focusing on medication classes like anticholinergics and beta-3 agonists. They explore patient-centered considerations such as medication compliance, cost, insurance coverage, and the chronic nature of overactive bladder management, emphasizing individualized treatment based on patient needs and health profiles.

Expert panelists review the AUA/SUFU guidelines for overactive bladder (OAB) treatment, discussing first-line behavioral strategies and the transition to pharmacological treatments.

Dr. Kennelly, Dr. Kevin Benson, and Dr. Karyn Eilber delve into the significant impact of OAB on patients' quality of life, including its effects on daily activities and mental well-being, and how this burden shapes clinical decisions in the early stages of treatment and selection of appropriate therapeutic options.

"In general, the majority of patients were very satisfied with the treatment," says Nitya E. Abraham, MD.

The real-world study plans to enroll 500 patients who are utilizing the Leva Pelvic Health System, a non-invasive medical device to help women train and strengthen pelvic floor muscles.

"I think some of the biggest advances have come in the surgical space," says Vikas Desai, MD.

“I definitely am more careful about who I offer Botox to in men,” says Gina M. Rooker, MD.