OAB and Incontinence

The coverage policy went into effect on December 28, 2023.

"Ask about leakage and talk about options," says Lindsay A. Hampson, MD, MAS.

"I think as urologists that treat incontinence, both Dr. Shaw and I probably have the experience of talking to many men who actually never pursue surgical treatment for their incontinence, but they still want to understand what the options are," says Lindsay A. Hampson, MD, MAS.

"I think the main [finding] that continues to strike me working with Dr Hampson on this type of work is how different individual incontinence is for the patient who is experiencing it," says Nathan M. Shaw, MD.

“[We can use] the study to help further those arguments that we should be able to make our clinical decisions based on the patient's presentation, a risk-benefit discussion between patient and physician, and not based on what insurance companies will pay for,” says Michelle E. Van Kuiken, MD.

"We found that less than 5% of people with incontinence had received a surgical intervention for their incontinence within a year of the survey," says Giulia I. Lane, MD, MS.

“Probably one of the most meaningful findings was that insurance type did influence the choice of medication first prescribed by urologists for overactive bladder,” says Michelle E. Van Kuiken, MD.

“The main rationale for this research was we felt like there was an unaddressed population of patients living with urinary incontinence,” says Nathan M. Shaw, MD.

In this Urology Times® episode, Dr. Kennelly, Dr. Kevin Benson, and Dr. Karyn Eilber discuss overactive bladder (OAB), focusing on its diagnosis, symptomatology, and patient populations most at risk, including gender and age-related factors.

All of those enrolled in the study have been implanted for at least 7 months, with the longest implantation at 15 months.

According to Neuspera, results from phase 2 of the SANS-UUI trial are expected to support an application for FDA approval of the device in patients with OAB-related UUI.

"This work and previous work supports the idea that EBV not only causes MS, but also continues to affect disease progression," write the authors.

The phase 2a open-label dose ascending study to assess the safety, tolerability, and efficacy of VMB-100 in female patients with moderate SUI is expected to begin in the first half of 2024.

"Overactive bladder symptoms have been shown to be influenced by these other areas in their life that can create a lot of stress and problems," says Raveen Syan, MD, FPMRS.

“Providers can use this information to counsel patients that that initial sticker shock goes away once you stick with that medication,” says Katherine Shapiro, MD.

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.