Dr. Abraham and Dr. Laudano discuss decisional regret after OAB treatment


"In general, the majority of patients were very satisfied with the treatment," says Nitya E. Abraham, MD.

In this video, Nitya E. Abraham, MD, and Melissa A. Laudano, MD, discuss the background and notable findings from the Neurourology and Urodynamics study “Do patients experience decisional regret after sacral neuromodulation for refractory overactive bladder?” Abraham is an associate professor of urology at Montefiore Medical Center/Albert Einstein College of Medicine in Bronx, New York. Laudano is an associate professor of urology and of obstetrics & gynecology and women's health at Montefiore Medical Center/Albert Einstein College of Medicine.

Abraham: Dr. Laudano and I treat a lot of patients with overactive bladder here at Montefiore in the Bronx, and we were curious to know if our patients were happy with the treatment that they were receiving. We specifically wanted to look at satisfaction with surgery and decisional regret. We looked back at our patient population who underwent sacral neuromodulation from 2015 to 2022. For about 190 patients, we had some someone on our research team call each patient and was able to get through to about 70% of them, and administer this validated questionnaire on decisional regret and satisfaction.

Laudano: We were happy to see that we had high levels of satisfaction and overall low levels of decisional regret in our patient population, which really does help us when counseling patients going forward who may be interested in this therapy.

Abraham: As we expected, there were patients who had more regret or lower satisfaction, and those were people who considered themselves to have experienced complications. But when we delved into it in more detail to find out what types of complications, 5 of them reported lack of efficacy, and 5 of them reported pain after the procedure. Overall, the complication rate was low—only 10 patients in the whole cohort. In general, the majority of patients were very satisfied with the treatment. How has this impacted your practice?

Laudano: I think it mostly has impacted our counseling preoperatively for these patients so that they can have a sense of what they might expect from the therapy. I think that is really so important when we think about treating patients, especially for many of these quality-of-life conditions that we treat, to just set forth some realistic expectations at the start of undergoing a therapy. This really does help us to provide future patients with some real data of what they can expect from our patient population, which sometimes is underrepresented in other larger studies.

Abraham: One of the strengths of our study was that we had about 3 years' follow-up, and I think future directions would be to get longer term follow-up and see at 5 years and even 10 years, if patients continue to be satisfied with the therapy.

This transcription was edited for clarity.

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