Female Urology: SUFU launches clinical care pathway for OAB patients

Benjamin M. Brucker, MDOther female urology topics discussed at this year's AUA meeting include preoperative urodynamics for women undergoing prolapse surgery and a study on nocturia.  The Female Urology/Incontinence/Urodynamics discussions were presented by Benjamin M. Brucker, MD, of New York University Langone Medical Center, New York.  

The Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction has launched a clinical care pathway and patient road map for overactive bladder, emphasizing evidence- and expertise-based approaches to improve patient compliance with OAB therapy.

A randomized trial involving patients with medication-refractory OAB demonstrated a significant reduction in daily urge urinary incontinence episodes with onabotulinumtoxinA (Botox) injection versus sacral neuromodulation, but botulinum was associated with a higher rate of urinary tract infection and need for transient catheterization.

Family income, as manifested by grocery spending and dietary quality, is a robust predictor of nocturia.

Low-dose desmopressin nasal spray (SER120) led to a significant reduction in episodes of nocturia in a randomized trial involving older patients.

A claims-based data analysis suggested a significantly higher rate of pelvic prolapse reoperation with vaginal versus abdominal primary repair.

Continue to the next page for more take-home messages

• Involvement of resident physicians did not adversely affect length of stay or 30-day perioperative outcomes following minimally invasive abdominal sarocolpopexy.

• Preoperative urodynamics for women undergoing prolapse surgery did not significantly affect perioperative management, aside from revealing occult stress urinary incontinence.

• The addition of bladder ultrasound during urodynamics assessment detected wall tension and stress not indicated by vesicle pressure catheterization.

• A retrospective multicenter analysis showed that a history of radiation therapy decreased time to idiopathic erosion of an artificial urinary sphincter.

• A preclinical study showed that long-term pudendal nerve electrical stimulation accelerated recovery from stress incontinence via increased neurotrophin expression and nerve regeneration, suggesting electrical stimulation may shorten postpartum duration of stress urinary incontinence and potentially reduce the risk of later SUI development.

More AUA take-home messages:

Minimally Invasive Surgery: Study shows huge variance with RALP cost

Infection/Inflamation: A new class of agents for IC shows promise

Infertility/Andrology: Are vasectomy and prostate Ca linked?

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