OAB and Incontinence

"Even just the process of getting that β3 agonist is going to cost them time and energy and effort that can be quite frustrating and take a lot out of you," says A. Lenore Ackerman, MD, PhD.

"The evidence is starting to show us that although efficacy in terms of managing OAB symptoms may be equal or similar across studies for these 2 classes of medications, safety and tolerability are very different," says A. Lenore Ackerman, MD, PhD.

"We are optimistic about this study, because it has the potential not just only for vesicovaginal fistula treatment, but it can be also used in the treatment of burns for other fistula types," says Ilaha Isali, MD.

“The first thing I'd say is that we know these devices are safe,” says Colin Goudelocke, MD.

"Our second line [for overactive bladder] is our medications. These often can be very effective for patients, but we find that they can be also extremely limited by adverse events that are associated with those medications," says A. Lenore Ackerman, MD, PhD.

The safety and efficacy of the Vivally System were established in the FREEOAB study, a prospective multi-center clinical trial that included 96 patients with overactive bladder.

“We might find that there's a certain type of patient that really thrives on interacting with the device and playing an active role in his or her therapy,” says Colin Goudelocke, MD.

“We recommend mirabegron monotherapy as an alternative medical treatment choice for the management of OAB,” the authors wrote.

Availability, expertise, and funding were the primary issues identified as barriers to use of sacral neuromodulation for the treatment of patients with overactive bladder.

“We do see that the device appears to be clinically efficacious,” says Colin Goudelocke, MD.

“This is a lifetime disease; you want to make sure that the battery not just has long enough life but still has the capacity,” says Colin Goudelocke, MD.

"I've worked in 3 different countries, I've seen dozens of people doing robotic radical prostatectomy...so my current practice is kind of a “best of” what I have seen and learned," says Ricardo Soares, MD.

"The results of this study demonstrate that peroneal eTNM using the URIS neuromodulation system is safe, well tolerated, and effective, with over 85% of patients experiencing clinically significant improvement in most bothersome OAB symptoms," says Jan Krhut, PhD.

"The overarching goal is to both increase the identification of patients with urinary incontinence as well as shorten the time between diagnosis and appropriate treatment," says David Sheyn, MD.

“You can really see the difference with the patients who go for physical therapy and the ones who don't,” says Ricardo M. de Oliveira Soares, MD.

“Whenever you're talking about the risk of incontinence, you should know your own data and not cite a specialist who has done a [large amount] of cases,” says Ricardo M. de Oliveira Soares, MD.

“When I'm discussing surgery, or any kind of treatment for prostate cancer, with patients, I always talk about the ‘trifecta,’ “ says Ricardo M. de Oliveira Soares, MD.

"Until a better option comes along, its low cost (mesh alone) and ease of use allows a standardized approach in an appropriately selected patient," writes Gopal H. Badlani, MD.

"What really surprised us was that 25% of our Botox cohort had previously undergone nerve stimulation, and those patients were less likely to stop Botox," says Katherine L. Woodburn, MD.

Yu Zheng, MD, and Eric Rovner, MD, physicans in the Department of Urology, Medical University of South Carolina provided an important apprasial of urethral bulking agents for stress urinary incontience in women in a recently published review.

"We noted in our overall population, which was about 214 women, there was a 40% discontinuation rate for Botox treatments in the office," says Katherine L. Woodburn, MD.

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.

“The takeaway is that sacral neuromodulation works well for men with overactive bladder and fecal incontinence, but perhaps less well for pelvic pain. We should see it as one of many multimodal treatments that we could offer for men with chronic pelvic pain,” says Dr. Elterman.

“With this study, we gained a better understanding of the features of third line therapy for overactive bladder, that patients find favorable and unfavorable,” says Anjali Kapur, MD.