OAB and Incontinence

In this installment of Urology Times' 50th Anniversary Innovation Celebration, Ekene A. Enemchukwu, MD, MPH, discusses the development of β3 agonists for the treatment of overactive bladder.

“We had fantastic completion of the study, and we were very pleased with the results,” says Samantha Pulliam, MD.

"β3 agonists really provided a new drug class of medications for patients with overactive bladder. Previously, there were no alternatives," says Ekene Enemchukwu, MD, MPH.

“In this subgroup analysis of data from the EMPOWUR trial, vibegron was associated with significant reductions in urgency episodes and micturitions compared with placebo in both the OAB dry and wet populations,” said lead author Jeffrey Frankel, MD.

“This is a unique device in that it shows motion-based biofeedback,” says Samantha Pulliam, MD.

At standard stimulation parameters, the Axonics F15 system is expected to function for 15+ years; at lower energy settings, this extends to 20+ years.

"The biggest improvement in my patients has been the urgency frequency and urgency incontinence, and even some of the patients with irritable bowel," says David W. Law, DO.

“I think the take home message is not to take sacral neuromodulation off the table,” says Sarah Martin, DO.

“We are not just changing toxins for the sake of changing toxins; we are changing toxins to satisfy the needs from the clinical community,” says Min Dong, MD.

“I think the take-home point here is that patient-centered care in the form of navigators to help support patients and provide those frequent check ins really appears to help improve adherence to therapy and progression to advanced therapies,” says Ekene Enemchukwu, MD, MPH.

“Of those patients that did the test phase 82% of them actually went on to full implants,” says Sarah Martin, DO.

“The biggest improvement in my patients has been the urgency frequency and urgency incontinence,” says David W. Law, DO.

“I think the main thing is placement of the neural probe on the first go around,” says David W. Law, DO.

“We really felt that this was an important question to ask because we know that OAB therapy adherence is associated with improvements in urinary symptoms, quality of life, and decreased OAB-related health care costs,” says Ekene Enemchukwu, MD, MPH.

“I think this is an extremely exciting space,” says Jai Seth, MD, BSc, MSc, FRCS.

“I think this really gave us an advantage to offer better care,” says Shiva J. Maralani, MD.

“I view OAB as a problem for many women that hasn't gotten the attention that it's needed over the decades,” says Alexandra Rogers, MD.

At standard stimulation parameters, the Axonics F15 system is expected to function for 15+ years; at lower energy settings, this extends to 20+ years.

Abstracts highlight topics such as sacral neuromodulation and percutaneous tibial nerve stimulation.

The device is indicated for overactive bladder, chronic fecal incontinence, and non-obstructive urinary retention.

The approval was based on results from a pivotal, open-label, single-arm trial that were published in the Journal of Urology.

“The prevalence of incontinence is high and increasing. We recommend routine screening for all women for this condition as a part of preventive health care,” says Ushma J. Patel, MD.

In this installment of the Urology Times' 50th Anniversary Innovation Celebration, Melissa R. Kaufman, MD, PhD, FACS, discusses the significance of onabotulinumtoxinA treatment in patients with overactive bladder.

"There have been few therapies that have so galvanized management of a urologic condition as what we've witnessed over the past decade regarding the use of onabotulinumtoxinA (Botox) for bladder dysfunction," says Melissa R. Kaufman, MD, PhD, FACS.

In this interview, Alexandra Rogers, MD, discusses how urologists can help patients with OAB feel normal.

“The most notable finding is that more than half of all adult US women experience urinary incontinence,” says Heidi Wendell Brown, MD, MAS, FACOG.

“Patients are overwhelmed by these choices often, and don't really understand the risks and benefits when they're first told about them,” said co-author Anjali Kapur, MD.

“Previous OAB studies could be inadvertently excluding large populations of patients due to language barriers, access to academic centers, collecting research data, or differences in beliefs in health care in general,” said co-author Beth Edelblute, MD, MPH.

“I think there's a disconnect between the patients saying they're interested in these therapies, and the patients that actually go on to [receive] them,” says Jason Kim, MD.

To analyze real-world data of urinary incontinence, Heidi Wendell Brown, MD, MAS, FACOG, Ushma J. Patel, MD, and co-authors conducted a study involving the 2015-2018 National Health and Nutrition Examination Survey (NHANES).