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Treatment of Ejaculatory Duct Obstruction by Seminal Vesiculoscopy Assisted Flow Modification
Published on: December 8, 2023
What treatment should we use if drugs fail for OAB; and, what really works after drugs?
J L H R Bosch1, C Kelleher, P E V van Kerrebroeck
1Department of Urology, University Medical Centre Utrecht, Utrecht, the Netherlands. j.l.h.r.bosch@umcutrecht.nl
Aims:
To determine (using structured brain storm sessions), which treatments should be used if drugs fail for OAB and to determine priority research questions in relation to this issue.
Methods:
A frame work for discussion was prepared by the chairman of the session; this included a brief summary of the currently existing evidence. Several experts had been asked to prepare a presentation of their personal treatment algorithm and to identify the [lack of] evidence for such an algorithm. These presentations were summarized by the chairman. Next, this summary was discussed with a large group of experts and opinion leaders and audio-recorded. The proceedings of this process are the basis for this manuscript.
Results:
The structured sessions resulted in detailed statements about: possible reasons for failure of conservative treatment, the evaluation of outcomes of RCT's, the use of botulinum toxin A in refractory OAB patients, the relative place of neuromodulation or sacral nerve stimulation and botulinum toxin A in the treatment of refractory OAB.
Conclusions:
A list of 10 unanswered questions and research topics was compiled. Additionally, 5 top priority research topics were identified.
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