OAB and Incontinence

Keith Xavier, MD, discusses the role of Altaviva in treating men with overactive bladder and urge urinary incontinence, including patient selection, clinical considerations, and its place among third-line therapies.

The next-generation implant is designed to extend the implant longevity from 10 years to 15 years.

The phase 2 trial will assess the safety and efficacy of ViXe, a product designed to deliver botulinum toxin directly into the bladder wall.

In this interview, Brett Trockman, MD, FACS, details how shifting guideline recommendations and expanding treatment options are allowing for more personalized approaches to sacral neuromodulation.

The device will be available over the counter in the US, with anticipated availability beginning in April 2026.

At SUFU 2026, 24-month data from the TITAN 2 trial showed that the Altaviva ITNM system provided sustained reductions in urgency urinary incontinence episodes, durable quality-of-life improvements, and a favorable safety profile through 24 months.

When symptoms appear tied to the menstrual cycle, pharmacologic options can be used as short-term support.

Aleece Fosnight, MSPAS, PA-C, highlights pattern recognition as a cornerstone of diagnosis, encouraging clinicians to closely examine how urinary symptoms fluctuate across the menstrual cycle.

Aleece Fosnight, MSPAS, PA-C, emphasizes that timing is one of the most valuable diagnostic clues.

Hormonal changes influence fluid balance and bloating, increasing pressure within the pelvis.

The safety and efficacy of the Revi System were established in the pivotal OASIS trial.

Aleece Fosnight, MSPAS, PA-C, argues that incontinence must be understood as a common, treatable medical condition rather than a personal failure or an inevitable part of aging.

Sameena A. Rahman, MD, emphasizes that menopause care requires precision medicine rather than a one-size-fits-all approach.

Once patients are ready to explore treatment, Fosnight stresses the importance of shared decision-making.

Aleece Fosnight, MSPAS, PA-C, encouraged urologists to normalize the conversation by openly acknowledging that these discussions can feel embarrassing but also by celebrating patients for taking the first step.

The new CPT code will be effective starting on July 1, 2026.

Aleece Fosnight, MSPAS, PA-C, highlights that although urinary leakage is common, it is not normal—and effective treatment options exist.

This announcement follows positive top-line data from a phase 1b/2a clinical trial of EG110A in patients with NDO following a spinal cord injury.

Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, IF, MSCP, HAES, emphasized that many older patients eventually pursue care only after years of coping, when their quality of life has been significantly affected.

A recap of the FDA submissions and regulatory decisions in urology from September 2025.

Fosnight described how stigma itself becomes a barrier to care, even though effective diagnostic and treatment options are available.

The Altaviva device is a minimally invasive implantable tibial neuromodulation therapy for patients with urge urinary incontinence.

Fosnight emphasizes that the cycle of shame, secrecy, and loneliness compounds the burden of urinary incontinence far beyond its physical effects.

The tool is designed as a patient-facing application that can be used both during clinic visits and independently at home.