Opinion
Video
What are considerations when selecting a neuromodulation technique for OAB?
Author(s):
"There are actually no data to support that 1 neuromodulation is better than another based on disease severity, and this is based on the systematic review done for the OAB guideline," says Anne Pelletier Cameron, MD, FRCSC, FPMRS.
In this video, Anne Pelletier Cameron, MD, FRCSC, FPMRS, discusses key considerations for selecting a neuromodulation technique in patients with overactive bladder. She was speaking at the 2025 Desai Sethi Urology Institute Urology on the Beach meeting. Cameron is the James Montie Legacy Professor of Urology at the University of Michigan and Associate Chair of Quality and Safety and Service Chief for the Department of Urology, and director of the Clinical Urology Research Endeavor.
Transcription:
What are key considerations for selecting the most appropriate neuromodulation technique for a specific patient with OAB, considering factors such as patient preference, disease severity, and potential complications?
I'll address disease severity first. There are actually no data to support that 1 neuromodulation is better than another based on disease severity, and this is based on the systematic review done for the OAB guideline. So we can't really say that 1 is better than the other. I know we all have preferences, and if you look at the data on sacral neuromodulation, it does get better continence results than, let's say, tibial nerve stimulation in the more severe patients. In more severe patients, I tend to direct them more toward sacral neuromodulation, because I think it actually provides better continence results. In terms of comorbidities, there are some clear directives, particularly in patients with dual incontinence, so in that patient who has fecal incontinence and bladder incontinence, we know that sacral neuromodulation is FDA approved for both indications, so it really makes sense to offer that patient a single treatment for 2 problems. That actually is a pretty rare event in medicine to have a single treatment to completely treat 2 separate problems. The other comorbidity that is very much on my mind is incomplete bladder emptying, those patients who have hesitancy or other types of non obstructive urinary retention, those patients do really well with sacral neuromodulation, again, because it targets the pelvic floor so directly, so they can empty better, and then their overactivity is relieved.
This transcription was AI generated and edited by human editors for clarity.
