The emperor has no clothes: OAB can be cured surgically

Area of Science:

• Urology
• Gynecology
• Pelvic Health

Background:

• A long-standing convention discouraged surgical treatment for urge urinary incontinence (UUI), now termed overactive bladder (OAB).
• This practice persisted despite evidence of surgical efficacy emerging in the late 1990s.

Purpose of the Study:

• To challenge the prevailing "no surgery" dogma for overactive bladder (OAB).
• To highlight the established surgical cure rates for OAB and related symptoms.
• To encourage further innovation in both surgical and non-surgical OAB treatments.

Main Methods:

• Review of 2,933 pelvic organ prolapse surgeries by Karjalainen et al. reporting on concurrent OAB treatment.
• Reference to early urodynamically controlled studies demonstrating surgical cure rates for UUI, frequency, and nocturia.

Main Results:

• Karjalainen et al. reported a 75% cure rate for bothersome urge urinary incontinence (UUI) in their review.
• Earlier studies demonstrated high cure rates (80-86%) for UUI, frequency, and nocturia following pubourethral ligament (PUL) and uterosacral ligament (USL) sling repair.

Conclusions:

• Surgical treatment for overactive bladder (OAB) has demonstrated significant efficacy for many years.
• The established success of OAB surgery should prompt a re-evaluation of treatment paradigms.
• Further research into both surgical and non-surgical approaches can offer new hope for affected women.