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Shifting the treatment paradigm in idiopathic overactive bladder
Arun Sahai1, Mo Belal2, Rizwan Hamid3
1Consultant Urologist, Guy's and St Thomas' Hospital, London, UK.
International Journal of Clinical Practice
|November 21, 2020
Summary
Overactive Bladder (OAB) management benefits from a new evidence-based algorithm for refractory cases. This approach guides treatment escalation beyond initial lifestyle changes and drug therapies for improved patient outcomes.
Area of Science:
- Urology
- Pharmacology
- Quality of Life Research
Background:
- Overactive Bladder (OAB) significantly impacts Health Related Quality of Life (HRQoL).
- Lifestyle modifications and behavioral therapy are initial OAB management steps.
- Pharmacological treatment is a key component in OAB management pathways.
Purpose of the Study:
- To review the evidence-based management of Overactive Bladder (OAB).
- To propose a novel treatment algorithm for escalating care in refractory OAB cases.
Main Methods:
- Literature review of OAB management strategies.
- Analysis of current and emerging therapeutic options.
Main Results:
- Antimuscarinic drugs are standard OAB treatments.
- Mirabegron (a β3 agonist) offers an alternative and combination therapy option.
- Refractory OAB may require invasive treatments like OnabotulinumtoxinA, sacral neuromodulation, or Percutaneous Tibial Nerve Stimulation (PTNS).
Conclusions:
- A new evidence-based treatment algorithm is proposed for refractory OAB.
- This algorithm aims to optimize treatment escalation for patients unresponsive to first-line therapies.
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