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Published on: August 28, 2020
[Update on the second line management of idiopathic overactive bladder]
E Chartier-Kastler1, D Castro-Diaz, D De Ridder
1Service d'urologie, groupe hospitalier Pitié-Salpêtrière, faculté de médecine Pierre-et-Marie-Curie, université Paris-VI, 83, boulevard de l'Hôpital, 75013 Paris, France. emmanuel.chartier-kastler@psl.aphp.fr
Summary
Overactive bladder syndrome (OAB) treatments like antimuscarinics often fail. This review examines sacral neuromodulation and botulinum toxin A as effective, minimally invasive alternatives for refractory OAB.
Area of Science:
- Urology
- Nephrology
Context:
- Overactive bladder syndrome (OAB) significantly impacts global quality of life.
- Conservative OAB treatments, including antimuscarinics, frequently result in treatment failure due to limited efficacy or side effects.
- Minimally invasive, reversible alternatives are crucial for managing refractory OAB.
Purpose:
- To review the clinical evidence on the efficacy and safety of sacral neuromodulation (SNM) and botulinum toxin A (BTX-A).
- To evaluate the current position of SNM and BTX-A in the second-line management of idiopathic OAB (IOAB).
Summary:
- Sacral neuromodulation (SNM) and botulinum toxin A (BTX-A) represent less radical, minimally invasive alternatives to surgery for OAB.
- SNM with InterStim Therapy is approved and recommended by the International Consultation on Incontinence (ICI) for OAB.
- Despite varying national practices, both SNM and BTX-A are utilized by urologists for treating idiopathic OAB.
Impact:
- Provides an updated clinical evidence summary for urologists managing refractory OAB.
- Informs treatment decisions regarding second-line therapies for idiopathic OAB.
- Highlights the growing role of minimally invasive neuromodulation and chemodenervation in OAB management.
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