OAB and Incontinence

Machine learning isn’t new to medicine or to urology, but its potential remains largely untapped, according to the authors of two new Cleveland Clinic–led studies.

The pharmacokinetic drug GEMTESA, developed by Urovant Sciences, was given to adult patients as a single 75-mg dose in a phase 1 study.

eCoin is a new technology for the management of bladder overactivity that is implanted near the posterior tibial nerve subcutaneously.

In this interview, Howard Goldman, MD, discusses the development of sacral neuromodulation as a treatment for overactive bladder (OAB).

"[Sacral neuromodulation has] changed the treatment of OAB remarkably," says Howard B. Goldman, MD, FACS.

“We wanted to compare outcomes between nursing home residents and community-dwelling older adults undergoing surgery for bladder and bowel dysfunction,” explains Anne M. Suskind, MD.

“When it comes to encouraging patients to utilize this therapy the number 1 thing I say is that it is the most effective therapy out there on the market,” says Raveen Syan, MD.

“I think my goal in doing all this research is to draw awareness to these problems and the disparities,” says Elisabeth M. Sebesta, MD.

“Health care disparities are very complex issues; it’s not like a linear cause-and-effect relationship,” says Elisabeth M. Sebesta, MD.

“[We] found that women were spending on average, nearly $35 a week on incontinence products in the highest symptom severity, which is a huge financial burden,” says Elisabeth M. Sebesta, MD.

“I’ve been using it my practice and also based on the literature, it seems like it is a relatively safe extract with little to no change in sexual function…and no obvious contraindications,” says Bilal Chughtai, MD.

Sacral neuromodulation administered through an implantable neurostimulator has shown promise as a therapy for patients with bladder and bowel dysfunction.

Axonics F15, a recharge-free sacral neuromodulation implantable neurostimulator for the treatment of patients with bladder and bowel dysfunction, was approved by the FDA earlier this year.

Cleveland Clinic specialist discusses the implications of the first published guideline for neurogenic lower urinary tract dysfunction

In this interview, Catherine Ann Matthews, MD, FACS, FACOG, discusses the resurgence of single-incision slings and outlines a clinical trial of slings that she is currently leading.

Urologists tend to prescribe more expensive drugs than nonurologists.

"A significant unmet need remains among long-term care residents with incontinence related to OAB,” said Sef Kurstjens, MD, PhD.

"Now with FDA approval, patients will have much improved ability to use this efficacious therapy on a long-term basis, which is most beneficial for them," Roger R. Dmochowski, MD, MMHC.

“The implications of the findings are that the SUI literature is, perhaps, not as good as it could be, but there’s hope,” says Eric S. Rovner, MD.

The investigators conducted a study that evaluated real-world urinary incontinence episodes and the benefit of onabotulinumtoxinA in individuals refractory to 1 or more oral medications.

"Looking back at the past 50 years, I recounted the achievements and yet-to-be-conquered goals," writes Gopal H. Badlani, MD.

Surgeons use single-port robot to achieve transvesical access to the vagina.

"With urge incontinence, the biggest advantage over the past few years is the emergence, and the proven efficacy, of the β-3 agonists, which are much better medications than the anticholinergic," says 1 urologist.

“New data indicate that long-term use of some of these overactive bladder drugs is not good for cognitive function,” explains Iglesia.

“Our algorithms were extremely accurate in predicting treatment response to both modalities. In fact, they could correctly predict which patient was a responder and which patient was a non-responder about 90% of the time in patients they had never seen before,” said Glenn Werneburg, MD, PhD.

“leva can help women successfully do pelvic floor muscle training and experience symptom resolution,” says Samantha Pulliam, MD.

In this installment of Urology Times' 50th Anniversary Innovation Celebration, Ekene A. Enemchukwu, MD, MPH, discusses the development of β3 agonists for the treatment of overactive bladder.

“We had fantastic completion of the study, and we were very pleased with the results,” says Samantha Pulliam, MD.

"β3 agonists really provided a new drug class of medications for patients with overactive bladder. Previously, there were no alternatives," says Ekene Enemchukwu, MD, MPH.

“In this subgroup analysis of data from the EMPOWUR trial, vibegron was associated with significant reductions in urgency episodes and micturitions compared with placebo in both the OAB dry and wet populations,” said lead author Jeffrey Frankel, MD.