2026 Urogynecology for the Advanced Practice Provider-Not Your Mother’s OAB: How to Approach OAB in 2026

Video Transcription

Video Summary

Dr. Courtney Moore, a urogynecology specialist at Ohio State University, presented an updated overview of overactive bladder (OAB) management and advanced therapies. She emphasized that OAB is common, costly, and underrecognized, affecting quality of life, sleep, sexual health, and fall risk. She noted that 2024 AUA guidelines now support a more flexible, non-linear treatment approach rather than strict first-, second-, and third-line therapy.<br /><br />First, she stressed foundational management: history, physical exam, urinalysis, selective PVR testing, fluid and caffeine reduction, pelvic floor muscle training, and weight loss. She also highlighted eco-friendly continence products and new options like PureWick. For medications, she reviewed antimuscarinics and beta-3 agonists, warning about cognitive side effects, urinary retention risk, glaucoma, and hypertension considerations. She favored trospium when cognitive risk is a concern.<br /><br />For minimally invasive options, she discussed Botox, posterior tibial nerve stimulation, sacral neuromodulation, and newer implantable tibial nerve stimulators. She explained their benefits, limitations, candidacy, and insurance barriers. She also addressed special populations such as patients with stress incontinence, prolapse, fecal incontinence, retention, pregnancy, and those using GLP-1 medications.<br /><br />Her main message: OAB care should be individualized, collaborative, and aimed at improving access to effective, patient-centered treatment.

Asset Subtitle

Comprehensive review of OAB guidelines incorporating new technology and treatments.

Speaker: Courtenay Moore, MD

Keywords

overactive bladder

urogynecology

AUA guidelines

pelvic floor muscle training

antimuscarinics

beta-3 agonists

Botox therapy

sacral neuromodulation