OAB and Incontinence

“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.

Optimal bedtime was determined using the bedtime and mid-awake time for each patient, which was gathered from an Actiwatch Spectrum device.

The tool uses clinical covariates to predict changes in storage, voiding, and nocturia LUTS for patients receiving placebo, dutasteride, tamsulosin, or DUT/TAM combination therapy.

Vivally System is a neuromodulation system that uses a closed-loop control algorithm and electromyography to personalize treatment for each patient.

"After 6 months, about 77% of this group have more than 50% improvement on their main symptom," says John Heesakkers, MD, PhD.

"This is something [that is] a lot easier for the patient, it's a lot less costly to the health care system to stay out of the operating room, and it's a lot quicker for me," says Howard B. Goldman, MD.

"Not only do we lose patients and we lose this opportunity to actually take good care of them, but it actually undermines their trust in us as a profession," says A. Lenore Ackerman, MD, PhD.

"The sad thing is that with something like OAB, we already have so many barriers to getting patients in to initiate care in the first place," says A. Lenore Ackerman, MD, PhD.

"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.