OAB and Incontinence

Suzette E. Sutherland, MD, MS, FPMRS, recaps the 2024 AUA session, “Panel Discussion: Which Type of Sling Is Best in the Index SUI Patient?”

"Overall, I think this study will allow clinicians to better advise patients in the slightly complex landscape of OAB therapies," says Leo Dreyfuss, MD.

"We really found from the study, clinicians who had wanted to potentially offer the safer alternative of a single-incision sling, we determined that in this circumstance, it was noninferior," says Catherine A. Matthews, MD, FACS, FACOG.

“Overall, I think this study will allow clinicians to better advise patients in the slightly complex landscape of OAB therapies,” says Leo Dreyfuss, MD.

"I think these findings suggest that for clinicians who treat a lot of older adults with neuromodulation, caution should be exhibited when recommending the single-stage approach," says Leo Dreyfuss, MD.

Yōni.Fit is a soft vaginal insert intended to reduce urine leakage due to SUI without interfering with voluntary urination.

"In the study, about two thirds of the residents did undergo PNE and one third underwent Stage 1, and those who underwent PNE were less likely to progress to device implant than Stage 1," says Leo Dreyfuss, MD.

"So I think these findings overall are reassuring and support the use of neuromodulation in this population," says Leo Dreyfuss, MD.

“Along those lines, we've taken away the traditional step therapy that has dictated overactive bladder care for quite some time,” says Ariana L. Smith, MD, FPMRS.

Urinary symptoms were not significantly improved from local estrogen use in most studies, though an improvement in vaginal symptoms was observed.

The Prescription Drug User Fee Act target action date is set for quarter 3 of this year.

Following the positive recommendation, the European Commission will now review the application for vibegron for potential approval in the OAB setting in all EU member states, as well as in Iceland, Liechtenstein, and Norway.

“This brand new guideline offers options for all patients with OAB with a focus on shared decision-making between patients with OAB and clinicians, as well as a personalized, tailored approach to care,” said Cameron and Smith.

Findings from the study showed a clinical response rate of 76.4% and 78.4% at 6- and 12-months following activation of the device among patients in the intent-to-treat population.

"There are plenty of articles written about stress-induced urgency. I, at the time, only found 1 article written in the gynecologic literature about what they called stand-up urgency," according to Colin Goudelocke, MD.

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.

Panelists conclude their discussion by reflecting on key learnings and sharing advice for patient-centric management in overactive bladder (OAB) treatment, specifically focusing on effective communication and overlooked aspects of patient care. They offer guidance to other providers on enhancing patient experiences, particularly with procedures like Botox. The episode wraps up with each expert sharing their final thoughts and anticipations for advancements in OAB treatment in 2024, highlighting their commitment to addressing patient needs in this evolving field.

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.

In this discussion, Dr. Kennelly, Dr. Kevin Benson, and Dr. Karyn Eilber share their approaches to post-procedure care and follow-up for overactive bladder (OAB) treatments. They detail the patient experience immediately after the procedure, the role of nursing and support staff, and methods for guiding patients through the recovery process, including managing potential complications and effective communication strategies. Additionally, they address challenges in patient adherence to follow-up visits, share insights on assessing treatment effectiveness during these visits, and discuss their strategies for enhancing patient engagement and satisfaction in their practices.

In this episode, Dr. Kennelly, Dr. Kevin Benson, and Dr. Karyn Eilber discuss their strategies for ensuring patient comfort during overactive bladder (OAB) treatment procedures. They delve into the roles of clinical staff, the setup of the procedure room, and how they address patient needs and concerns to create a reassuring environment. The experts also share their experiences in handling challenges during procedures, illustrating how they've adapted their practices based on patient feedback to maintain a patient-centric focus throughout the treatment process.