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Initial clinical experience with selective bladder denervation for refractory overactive bladder.

Le Mai Tu1, Stefan De Wachter2, Magali Robert3

  • 1Division of Urology, Department of Surgery, Sherbrooke University Hospital, Sherbrooke, Quebec, Canada.

Neurourology and Urodynamics
|December 1, 2018
PubMed
Summary
This summary is machine-generated.

Selective bladder denervation (SBD) effectively treats refractory overactive bladder (OAB) in women. A longer radiofrequency (RF) duration (60-s) showed superior symptom improvement and comparable safety to a shorter duration (10-s) SBD procedure.

Keywords:
ablationafferent nervesfulgurationmicturitionminimally invasiveradiofrequencytrigone

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Female Pelvic Medicine

Background:

  • Refractory overactive bladder (OAB) significantly impacts quality of life.
  • Current treatments for refractory OAB have limitations.
  • Selective bladder denervation (SBD) offers a potential new therapeutic avenue.

Purpose of the Study:

  • To evaluate the initial clinical outcomes of selective bladder denervation (SBD) of the trigone in women with refractory OAB.
  • To compare the efficacy and safety of two radiofrequency (RF) durations for SBD.
  • To assess the impact of SBD on OAB symptom severity and patient-reported outcomes.

Main Methods:

  • Sixty-three female patients with refractory OAB underwent SBD of the bladder sub-trigone region.
  • Initial patients received a 10-second voltage-controlled RF (RF10) treatment, while subsequent patients received a 60-second temperature-controlled RF (RF60) treatment.
  • Patients were followed for 12 weeks to assess adverse events and changes in OAB symptoms, with exploratory analyses on RF duration.

Main Results:

  • SBD demonstrated statistically significant and clinically important improvements in most OAB symptoms.
  • The 60-s RF algorithm (RF60) resulted in greater reductions in urgency urinary incontinence, urinary incontinence, and urgency/frequency scores compared to the 10-s RF algorithm (RF10).
  • Treatment responders were significantly higher with RF60 (79%) versus RF10 (31%), with comparable rates of adverse events.

Conclusions:

  • Selective bladder denervation (SBD) is a feasible procedure for alleviating refractory OAB symptoms.
  • A 60-second RF algorithm for SBD is more effective than a 10-second algorithm, offering comparable safety.
  • SBD, particularly with longer RF duration, represents a promising treatment for women with refractory OAB.