OAB and Incontinence

Experts close their panel on OAB by identifying treatment pathways for patients who have an unsatisfactory response to third-line therapy.

“When you're talking about Medicare patients who are on multiple medications, and this is not the only thing that they're taking, to pay over $100 for 1 medication is sometimes not possible,” says Katherine Shapiro, MD.

These findings may help guide decision-making in the initial testing phase of the [sacral neuromodulation] device prior to permanent implant or explant, according to Bradley Gill, MD, of the Cleveland Clinic.

“Our aim overall is to describe Medicare Part D prescription drug coverage and use of prior authorization and step therapy for these medications,” says Katherine Shapiro, MD.

An overview of patient monitoring strategies experts use to establish individualized followup with patients receiving therapy for OAB in the third-line setting.

Focused discussion on effectively communicating expectations for third-line therapies with patients being treated for OAB.

"I treat all aspects of male and female incontinence, whether this be artificial urinary sphincter, the male sling, female sling, bladder Botox, or sacral neuromodulation," said Jas Singh, MD, FRCS.

Experts provide their perspective on the advent of third-line therapy in OAB and discuss details in the clinical process of transitioning patients out of the second-line setting.

Panelists identify key goals of therapy when treating OAB and identify resources that may aid in patient education.

Shared insight on strategies used to converse with and educate patients on pharmacologic treatment options for OAB, including the potential for adverse events tied to therapy.

In total, the prospective SOPHIA study enrolled 6 men with stress urinary incontinence who have reduced outlet resistance due to intrinsic sphincter deficiency.

The phase 3 URO-901-3005 study met its 2 co-primary end points with vibegron demonstrating a reduction in micturition episodes and urgency episodes from baseline to 12 weeks.

The FDA's decision was based on results from the OASIS trial, in which the Revi tibial neurostimulator device demonstrated significant efficacy for treating urge urinary incontinence in women.

Experts outline their clinical approach to identifying treatment failure in patients on initial pharmacologic treatment for OAB and strategies for subsequent treatment selection.

A comprehensive discussion on clinical factors that impact pharmacologic treatment selection in patients with OAB.

Panelists introduce the available treatment modalities for OAB, including behavioral modification, pharmacologic treatment, neuromodulation, and surgical approaches.

"Despite prevalent OAB symptoms, only 6% of all LUTS prescriptions in men were for OAB medications," says Sarah Neu, MD, MSd, FRCSC.

A brief overview of how and when providers incorporate urodynamic testing as part of the diagnostic workup for OAB.

Panelists further expand on the typical clinical characteristics of patients with OAB who they see in their practice, common signs and symptoms, and potential differential diagnoses.

The UroActive device is currently being studied in the SOPHIA study, which published initial results earlier this year.

Experts begin their panel discussion on OAB by describing the typical diagnostic process and initial conversations that they have with patients suspected of having the condition.

Urologist Benjamin Brucker, MD, urogynecologist Eman Elkadry, MD, and nurse practitioner Jenna Horton, NP introduce themselves, outline their credentials, and briefly describe the patients with overactive bladder (OAB) who they typically see in their clinical practice.

UroMonitor was developed in response to conventional urodynamics, which have several limitations.

“There are a lot of social determinants of health as it relates to urge urinary incontinence,” says Joseph Kim, MD.

"It's certainly a bigger problem with advancing age in the geriatric population, and it can be a tremendous source of cost for patients who have these issues," says Gina M. Rooker, MD.

"Our main finding was that participants who experienced food insecurity in the past year were at 55% increased odds of reporting at least 1 episode of urge urinary incontinence in the past month, compared with those who have not experienced food insecurity," says Joseph Kim, MD.

The study assessed 120 women with overactive bladder for associations between anxiety and somatic symptoms, quality of life, quantitative sensory testing measures, and psychological stress symptoms.

"The improvement is sustained, but over time it does tend to decrease and we're currently trying to figure out why," says David Sheyn, MD.