Do Patients Discontinue Overactive Bladder Medications after Sacral Neuromodulation?

Area of Science:

• Urology
• Neurology
• Pharmacology

Background:

• Overactive bladder (OAB) medications often have limited efficacy and poor tolerability.
• Many patients with refractory OAB progress to third-line treatments like sacral neuromodulation (SNM).
• SNM may offer symptom improvement while avoiding OAB medication side effects.

Purpose of the Study:

• To evaluate the rate of discontinuing OAB medications post-SNM in patients with refractory OAB.
• To assess if SNM allows patients to avoid OAB medications after treatment.

Main Methods:

• A prospectively collected database of patients undergoing SNM was queried.
• Patients with urinary retention or early device removal were excluded.
• Clinical characteristics, urodynamic parameters, and medication use (via prescription database) were assessed.

Main Results:

• 82.1% of patients discontinued OAB medications after SNM (SNM-only group).
• 14.1% continued OAB medications for over a year post-SNM (concurrent group).
• No significant differences in outcomes (BMI, gender, PGI-I, etc.) were found between groups, though concurrent patients were older.

Conclusions:

• Over 80% of patients with refractory OAB discontinue OAB medications after SNM.
• SNM is an effective strategy for refractory OAB, allowing patients to avoid medication-related side effects.
• Similar outcomes were observed in patients who discontinued or continued OAB medications post-SNM.