Current management of refractory overactive bladder

AbstractOveractive bladder (OAB) is a common condition affecting one ‐sixth to one‐fifth of the global population. The treatment of refractory OAB remains a challenge for urologists. Current treatment options include the use of combination therapy with antimuscarinic agents and beta‐3 adrenoceptor agonists, and treating underlying curable disorders. Intravesica l botulinum toxin type A (BoNT‐A) injection, percutaneous tibial nerve stimulation, and sacral nerve stimulation are third‐line management therapies suggested by the American Urological Association/Society of Urodynamics, Female Pelvic Medicine&Urogenital Reconstruction (AUA/SUFU) guidelines. In rare cases, more invasive surgical interventions can be considered after explaining the benefits and risks to the patients. Augmentation cystoplasty has a high success rate; however, it has also been associated with a high complication rate. In contrast, detrusor myomectomy is an easy procedure, but the treatment outcome remains controversial. Liposome ‐encapsulated BoNT‐A is administered via bladder instillation, and promising results have been obtained in preliminary studies. More therapies are currently being investigated, and transient receptor potential vanilloid 1 antagonists may be new type of medication. Radiofrequency ablation and oth er targets for neuromodulation have also been studied; however, more evidence is needed to confirm their efficacy.
Source: LUTS: Lower Urinary Tract Symptoms - Category: Urology & Nephrology Authors: Tags: REVIEW ARTICLE Source Type: research

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AbstractPurpose of ReviewWe review the current literature pertaining to recommendations for selecting appropriate patients and performing a test phase for sacral neuromodulation.Recent FindingsCurrent literature reveals that this therapy can be successfully offered to patients with mild and severe forms of refractory overactive bladder, wet or dry. It can also be offered to elderly patients and patients with concurrent fecal incontinence, even in the setting of a known history of obstetric anal sphincter injury. Patients with non-obstructive urinary retention should be carefully selected with other etiologies ruled out, an...
Source: Current Bladder Dysfunction Reports - Category: Urology & Nephrology Source Type: research
Condition:   Stress Urinary Incontinence Intervention:   Procedure: mid-urethral sling procedure Sponsor:   Far Eastern Memorial Hospital Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
AbstractIntroduction and hypothesisA systematic survey on the association between childhood nocturnal enuresis (CNE) and adult pelvic floor disorders (PFDs) has not been presented previously. The aim was to describe the prevalence of PFDs and lower urinary tract symptoms in nulliparous women, with or without a history of CNE, at the age of ≥ 5 years.MethodsThis national survey of urinary (UI) and fecal incontinence (FI) and symptoms of pelvic organ prolapse (sPOP) was a random sample of 20,000 nulliparous women aged 25 –64 years conducted in 2014. Women ≥ 5 years of age having CNE were compared w...
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
We describe the technical aspects of recent developed implants and techniques of tibial nerve stimulation in a transcutaneous, percutaneous, and minimal invasive way. All different treatment options have advantages and disadvantages based on type of surgery, energy transfer, impedance, treatment setting options, risk of migration, and patient usability, which are described in this review. Only devices with data that are publicly available were included. Summary New technologies are on their way in the field of tibial nerve stimulation for the treatment of OAB. Technical aspects are important to demonstrate safety and ef...
Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: NEUROUROLOGY AND INCONTINENCE: Edited by John Heesakkers and Frank Martens Source Type: research
To determine the relationship between subcutaneous fat (SFA), visceral fat surface area (VFA), bladder wall fat distribution, and visceral adiposity index (VAI) as risk factors for overactive bladder (OAB) occurrence.
Source: Urology - Category: Urology & Nephrology Authors: Tags: Female Urology Source Type: research
AbstractPurpose of ReviewThere is growing evidence supporting the use of percutaneous tibial nerve stimulation to manage lower urinary tract symptoms (LUTS) such as urgency, frequency and urge incontinence, in a non-pharmacologic, minimally invasive approach. Given this, there is now an impetus to move this technology forward from an interval (i.e., weekly and/or monthly) toward a continuous dosing, using implantable devices. This review article focuses on the newest implantable devices and the most current data demonstrating safety and efficacy in the management of refractory overactive bladder.Recent FindingsThere are ne...
Source: Current Urology Reports - Category: Urology & Nephrology Source Type: research
Medications save lives and/or increase the quality of life for many people. Yet, there are few if any medications that have no side effects, many of which may negatively affect the brain or other organs of the body. In fact, the National Institutes of Health (NIH) says there is evidence that some overactive bladder medications (OBMs) can cause issues that are similar to Alzheimer’s and may, in some cases, even contribute to triggering symptoms.  “Our study indicates an association between taking oxybutynin, solifenacin, and tolterodine and the subsequent diagnosis of dementia in DM patients. More...
Source: Minding Our Elders - Category: Geriatrics Authors: Source Type: blogs
This study is aimed to systematically evaluate the efficacy of tamsulosin combined with solifenacin and provide clinical evidence for treatment of benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS). PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang data information service platform were searched to select randomized controlled trials (RCTs) of tamsulosin combined with solifenacin in the treatment of BPH with LUTS. After extraction of the data, the statistical information was calculated by means of STATA 12.0. The publicati...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusions: This study comprises the first review of walking-evoked erection in patients with lumbar degenerative diseases. We speculate that sensory input, such as paresthesia in the genitalia or perianal region stimulates the pelvic or perineal nerves through the pudendal nerve and induces reflexogenic erections. PMID: 32429018 [PubMed - as supplied by publisher]
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
AbstractIntroduction and hypothesisThe association between overactive bladder (OAB) and uterine prolapse remains unclear. The extent of the role of serum nerve growth factor (NGF) levels in this relationship is also not known. Therefore, our study evaluated the association among OAB, high-grade uterine prolapse and serum NGF levels.MethodsA total of 90 patients participated in our study and were grouped as follows. Group I included patients with high-grade uterine prolapse and OAB, group II included patients with only high-grade uterine prolapse, and group III included healthy women without uterine prolapse or OAB. Serum N...
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
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