E-Posters-Review of Advanced Therapies for Refractory Overactive Bladder

Review of Advanced Therapies for Refractory Overactive Bladder - Nadia Megahed, MD

Pdf Summary

This study reviewed advanced therapies for refractory overactive bladder (OAB), including percutaneous tibial nerve stimulation (PTNS), sacral nerve stimulation (SNS), and intradetrusor onabotulinumtoxinA (Botox) injections. The objective was to study the factors associated with patient and physician decision-making when choosing an advanced therapy option.<br /><br />The data revealed that PTNS was associated with increasing patient age and a higher number of previous OAB medication use. SNS had a longer interval to second therapy compared to PTNS or Botox, which may have been due to provider preference. Larger studies are needed to further understand the decision-making process for advanced therapies for refractory OAB.<br /><br />The mean age at the time of the first procedure was 63.2 years. For each additional year of age, the odds of PTNS as the initial form of advanced therapy increased compared to SNS. PTNS was chosen as the initial therapy twice as often when patients had tried more than 2 previous medications for OAB, compared to Botox and SNS.<br /><br />Of the 132 patients, 20 required a second advanced therapy. PTNS was started as the second therapy an average of 1.4 years after the initial advanced therapy, Botox at 1.9 years, and SNS at 5.7 years. There was no significant association between the initial failed therapy and subsequent therapy. Complication rates in the first advanced therapy did not have a significant association with the type of second therapy used.<br /><br />This study was a single-center, retrospective chart review evaluating patients with refractory OAB. Procedure codes were used to identify female patients who underwent initial treatment for refractory OAB. Patient demographics, treatment dates, medical history, and previous medication use were collected.<br /><br />In conclusion, this study provides insight into the factors associated with the choice of advanced therapies for refractory OAB. Further research, including larger-scale studies, is needed to fully understand the decision-making process and complexities of these therapies.

Keywords

advanced therapies

refractory overactive bladder

percutaneous tibial nerve stimulation

PTNS

sacral nerve stimulation

SNS

intradetrusor onabotulinumtoxinA

Botox injections

patient decision-making

physician decision-making