Neurourology and Urodynamics最新文献

{"title":"Impact of Bladder Management Strategies on Autonomic Dysreflexia Severity in People With Spinal Cord Injuries.","authors":"Rita Palanjian, Blayne Welk, Jeremy B Myers, Sara M Lenherr, Sean P Elliott, Diana O'Dell, John T Stoffel","doi":"10.1002/nau.70002","DOIUrl":"https://doi.org/10.1002/nau.70002","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated whether severity of autonomic dysreflexia (AD) was associated with more patient-reported bladder and bowel symptoms and compared AD severity by bladder management strategy in people with spinal cord injury (SCI).</p><p><strong>Methods: </strong>The Neurogenic Bladder Research Group SCI Registry is a prospective study which evaluated quality of life after SCI. Bladder and bowel symptoms were assessed through Neurogenic Bladder Symptom Score and Neurogenic Bowel Dysfunction score, respectively. AD severity was assessed with the Autonomic Dysreflexia Following Spinal Cord Injury (ADFSCI) instrument. Bladder management was classified as volitional voiding, clean intermittent catheterization (CIC), indwelling catheter (IDC), and surgery (augmentation and diversion).</p><p><strong>Results: </strong>AD scores were identified for 1473 people. The mean age was 45. Bladder management was CIC in 754 (51%), IDC in 271 (18%), surgery in 195 (13%) and voiding in 259 (18%). On univariate analysis, higher ADFSCI scores occurred with complete injuries (3.1 vs 3.4, p = 0.03), cervical/thoracic injuries (3.8 vs 1.5, p < 0.0001), and chronic pain (3.9 vs 2.9, p = 0.0004). IDC (5.2) and surgery (4.5) had higher ADFSCI scores than CIC (3.0) and volitional voiding (2.8) (p < 0.0001). Sub-analysis showed bladder augmentation had significantly higher ADSCI scores than diversion (4.7 vs 3.7, p = 0.03). On multivariate analysis, level of injury, bladder management, and bowel and bladder symptoms remained associated with worse AD.</p><p><strong>Conclusion: </strong>Level of injury, age, worse bowel and bladder symptoms and bladder management type were associated with higher AD scores. Bladder management with surgery, particularly bladder augment, and IDC had associated greater AD symptoms compared to CIC or voiding.</p><p><strong>Trial registration: </strong>clinicaltrials.gov NTC06216081 and HSRP20153564, U.S. National Library of Medicine, wwwcf.nlm.nih.gov.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Baseline Urodynamic Findings Predict the Outcomes and Complications of Intravesical Injections of Onabotulinum Toxin A for Overactive Bladder?","authors":"Kristina Aleksejeva, Gemma Scrimgeour, Richard Axell, Habiba Yasmin, Mahreen Pakzad, Jeremy Ockrim, Tamsin Greenwell","doi":"10.1002/nau.70000","DOIUrl":"https://doi.org/10.1002/nau.70000","url":null,"abstract":"<p><strong>Introduction: </strong>Intravesical Onabotulinum Toxin A (Botox A) injections are an established minimally invasive therapy option for the treatment of refractory overactive bladder (OAB) symptoms in adults. We have assessed whether baseline urodynamic findings can predict self-reported patient outcomes and posttreatment voiding difficulties.</p><p><strong>Methods: </strong>We have conducted a retrospective review of 407 patients (median age 61 years, range 22-94 years, 286 women) who have received intravesical Botox A injections for refractory non-neurogenic OAB symptoms between 2006 and 2018. Patient outcomes were assessed using the 5-point PGI-I scale and incidence of posttreatment voiding difficulties was noted. Results were correlated with the baseline urodynamic findings.</p><p><strong>Results: </strong>Good response to Botox A injections was defined as PGI-I scores of 1 and 2, and was seen in 272 patients overall (67%). Women were significantly more likely to have successful outcomes comparing to men (p = 0.034) and the voiding detrusor contraction duration (DCD) was a further classifier for treatment success. Acute posttreatment voiding difficulties requiring catheterization were observed in 96 patients (24%) and were significantly more likely in those with good response.</p><p><strong>Conclusion: </strong>Successful outcomes (based on the self-reported PGI-I score) were more likely in women and correlated positively with the increased duration of voiding detrusor contraction, but no other urodynamic parameters. The risk of developing de novo need to catheterize correlated with patient reported benefit, but not with any baseline urodynamic findings. We did not find pre-existing bladder outflow obstruction, concurrent stress urinary incontinence or complex previous surgical history to adversely affect treatment success.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of the Oral Treatment Options for the Management of Detrusor Sphincter Dyssynergia.","authors":"Angélique Tousignant, Marc-Antoine Blais, Le Mai Tu, Mélanie Morin, Salima Ismail","doi":"10.1002/nau.25642","DOIUrl":"https://doi.org/10.1002/nau.25642","url":null,"abstract":"<p><strong>Background: </strong>Adult neurogenic lower urinary tract dysfunction may be associated with detrusor sphincter dyssynergia (DSD). Given the sparsity of the literature and the absence of official guidelines regarding the use of oral medications in the management of DSD, this scoping review aims to critically assess the available evidence to guide future research and practice.</p><p><strong>Methods: </strong>We conducted a systematic scoping review of articles published from 1950 to July 2023 using PubMed, MedLine, Scopus and CINAHL databases to assess all oral treatment options for DSD. All study designs were included. The search was limited to English and French literature regarding human patients over 18 years of age with DSD.</p><p><strong>Results: </strong>Of the 899 records screened, 15 studies were included, involving a total of 257 participants. Alpha-adrenergic blockers, nitric oxyde and muscle relaxants have been used in the treatment of DSD. A decrease of postvoid residual volumes and an improvement of symptom scores as well as urine flow rates were reported in several studies. Regarding the alpha-adrenergic blockers, five of the six studies that detailed postvoid residual volumes and subjective improvement noted benefits in most patients. Additionally, two of the three studies that addressed mean flow rate observed improvements in most patients. All six studies that documented adverse effects found side effects in only a slight minority of patients.</p><p><strong>Conclusions: </strong>Alpha-adrenergic blockers are promising, but there is lacking evidence on the oral treatment of DSD. This study highlights the importance of conducting more studies to draw solid conclusions and stop treating these patients empirically.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Anatomical Pathogenesis for Science and Surgery of the Working Group's Recommendations for Female Stress Urinary Incontinence.","authors":"Peter E P Petros","doi":"10.1002/nau.25629","DOIUrl":"10.1002/nau.25629","url":null,"abstract":"<p><strong>Aims: </strong>To provide a brief anatomical pathogenesis of the Working Group SUI publication recommendations.</p><p><strong>Methods and results: </strong>The anatomical science and surgical practice presented here formed the original basis for the MUS and other bladder dysfunctions, updated to 2024 with videos: https://atm.amegroups.org/issue/view/1400. Bladder control is binary, from outside the bladder, with ONLY two modes, EITHER closed (continence) OR open (micturition). The key concept for surgical repair of stress (SUI) and other types of urinary dysfunctions, is the role of three balanced oppositely-acting muscle forces which contract against PUL (pubourethral ligament) and USL (uterosacral ligaments) to close urethra, open it before evacuation and stretch vagina to prevent premature activation of micturition, perceived as \"urge to go.\" Collagen-induced weakness in PUL or USL may cause dysfunction in all three of these activities, which can be improved or cured by collagen-creating ligament repair techniques (e.g., slings). It is important to diagnose Tethered Vagina Syndrome (TVS), iatrogenic scarring at bladder neck, much more frequent since large vaginal mesh implantation. TVS is often confused with SUI, as its cardinal symptom is massive urine loss with the \"effort\" of getting out of bed. Sling surgery worsens TVS as it adds more scar. Vaginal skin graft is required to restore elasticity and continence.</p><p><strong>Conclusions: </strong>\"Anatomical defects in binary control may cause SUI, retention or urge,\" and are potentially repairable. With regard to SUI, \"a normal PUL does not lengthen during effort.\"</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"409-415"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Adding TENS to Pelvic Floor Rehabilitation Effect on Urodynamics and Clinical Results in Children With Spina Bifida?","authors":"Özge Özdemir Ayla, Ş Kerem Özel, Gönül Acar, İbrahim Alataş","doi":"10.1002/nau.25628","DOIUrl":"10.1002/nau.25628","url":null,"abstract":"<p><strong>Introduction: </strong>Children with spina bifida (SB) experience a reduced quality of life due to neurogenic bladder dysfunction and the risk of renal failure later in life. Pelvic floor rehabilitation (PFR) and transcutaneous electrical nerve stimulation (TENS) have gained prominence in recent years due to their positive effects in treating different types of bladder issues in both adults and children. Our study aims to investigate the effects of using these two methods together in children with SB and to delineate their potential value for clinical practice.</p><p><strong>Materials and methods: </strong>Children with neurogenic bladder dysfunction due to SB who admitted to our spina bifida center were enrolled. Those patients, between 5 and 15 years of age, with only neurogenic detrusor overactivity (NDO) were randomly divided into two groups using an online computer application. While only the PFR was applied to Group PFR (n = 14), TENS was used in addition to this therapy in Group PFR + T (n = 14). The PFR sessions included abdominal massage, strength exercises, diaphragmatic breathing exercises, and contracting pelvic floor muscles. TENS was used in a standard fashion as previously described in patients with SB. Before and after treatment, patients' clinical data, dysfunctional voiding symptom score (DVSS), lower urinary tract symptoms, and quality of life scores due to urinary incontinence were evaluated. Urodynamic outcomes such as detrusor pressure, bladder capacity, contractility, and residual urine amount were also evaluated.</p><p><strong>Results: </strong>Twenty eight children out of 750 SB patients were enrolled in our center. Children with only NDO due to SB were included in the study (Group PFR, mean age 8.3 ± + 2.7 years, 10 boys, four girls; Group PFR + T, 7.86 ± 2.03 years, eight boys, six girls). Treatment duration was 6 weeks (18 sessions). There was a decrease in voiding and lower urinary tract symptoms in both groups regardless of the use of TENS (p < 0.05). Maximum detrusor pressure significantly decreased only in the TENS group after treatment (from 82.143 ± 58.069 cmH2O to 58.077 ± 39.872 cmH2O) (p < 0.05). The difference in clinical parameters, quality of life scores and other urodynamic parameters were not found to be significant between groups.</p><p><strong>Discussion: </strong>PFR and TENS may be effective in SB with NDO to reduce voiding symptoms, and protect bladder from increased pressures. PFR seems to be a useful conservative approach in patients with NDO, adjunt to standard treatment. Further studies are needed in delineation of a personalized holistic treatment approach in these patients.</p><p><strong>Conclusion: </strong>Addition of TENS to standard PFR in NDO may be effective in reducing maximum detrusor pressures, however, it does not seem to specifically contribute for improving incontinence and incontinence-related quality of life.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"451-457"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Reported Outcomes Due to Bladder Neck Obstruction in Women Treated With Botulinum Toxin A Injection.","authors":"Darrel Bibicheff, Brittany Lee Roberts, Dyer Pettijohn, Priscilla Rodriguez, Jessmehar Walia, Elise J B De","doi":"10.1002/nau.25626","DOIUrl":"10.1002/nau.25626","url":null,"abstract":"<p><strong>Introduction: </strong>Primary bladder neck obstruction (BNO) occurs when the bladder neck fails to open during voiding, causing urinary symptoms despite no anatomic obstruction. The cause of BNO is unclear but may involve neurogenic dysregulation related to the sympathic nervous system such as upper motor neuron lesion or peripheral autonomic neuropathy (small fiber neuropathy (SFN)). Another etiology can incuded increased sympathetic tone secondary to anxiety or stress conditons. Botulinum toxin A (BoNT-A) to the bladder neck has been used in our practice to treat women with BNO who failed conventional therapies (alpha blockers, relaxation strategies). This is the first report of patient-reported outcomes after BoNT-A treatment in women with pelvic pain and BNO.</p><p><strong>Materials and methods: </strong>We included female patients with pelvic pain and BNO who received BoNT-A to the bladder neck between January 2022 and March 2023, and mailed self-reported outcome questionnaires. The primary outcome was the Global Response Assessment (GRA); secondary outcomes included pain scores on the Visual Analogue Scale (VAS) and symptom checklists. BNO was diagnosed using Nitti Criteria (high bladder pressure, low flow in bladder neck on video urodynamics), supplemented by additional criteria (e.g., high voiding pressure, prolonged attempts, Valsalva effort, and cystoscopic evidence or symptoms related to BNO). Urodynamic studies followed International Continence Society standards. Additionally, due to BNO's association with SFN, patient history of biopsy-confirmed SFN was recorded.</p><p><strong>Results: </strong>Our inclusion criteria was satisfied among 18 patietns, with 17 completing the questionnaire. Out of those, 14 patients (77%) reported improvement on the GRA, with an average VAS of 8.3 (\"Very Helpful\"). The most commonly improved symptoms were feeling of incomplete emptying, difficulty starting stream, urethral burning, pain with urination, and pelvic pain. Postoperative symptom flares were reported in six patients for an average of 16 days. All six patients with biopsy-confirmed SFN showed significant improvement (VAS 8.7). Total of 14 patients (77%) indicated they would repeat the procedure.</p><p><strong>Conclusions: </strong>BoNT-A to the bladder neck significantly improved pelvic pain and refractory hesitancy in women with bladder neck obstruction, especially in those with small fiber neuropathy. Symptom flares are common, but did not reduce interest in repeated treatments, and scheduling injections before symptom recurrence may mitigate these flares.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"305-310"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Posterior Tibial Nerve Stimulation on Early Continence Following Extraperitoneal Laparoscopic Radical Prostatectomy With Three Trocars.","authors":"Yigit Akin, Enis Mert Yorulmaz, Osman Kose, Serkan Ozcan, Sacit Nuri Gorgel, Erbay Tumer","doi":"10.1002/nau.25659","DOIUrl":"10.1002/nau.25659","url":null,"abstract":"<p><strong>Aim: </strong>Posterior tibial nerve stimulation (PTNS) might stimulate the sacral nerves and lead to work pelvic floor muscles. We evaluated to effects of PTNS on continence results after extraperitoneal laparoscopic radical prostatectomy (eLRP) with three trocars during early post operative period.</p><p><strong>Methods: </strong>Prospectively recorded data of eLRP with three trocars was retrospectively reviewed for continence results between January 2017 and April 2024. Demographic, clinical, and follow-up data including age, prostate-specific antigen, prostate volume, nerve sparing surgery, and Gleason score were considered for match-paired analysis criteria. Patients were divided into two groups according to whether received PTNS therapy after surgery or not. Group 1 consisted of patients without PTNS (n = 66), and Group 2 consisted of patients who were applied PTNS (n = 66) after eLRP. Continence status, urine loss ratio (ULR), ICIQ-SF, and SF-12 Quality of Life Scale were recorded during outpatient control after 2nd, 3rd, 6th and 12th months of surgery. Statistically significant p was p ≤ 0.05.</p><p><strong>Results: </strong>Mean follow-up was 25 ± 8.7 months. There were 66 patients in each group and match-paired analyses were performed. Group 2 had significant lower incontinence rate and ICIQ-SF score at second and third months follow-up (p = 0.026 and p = 0.045; p = 0.044 and p = 0.031 respectively). Group 2 had significantly higher Physical Component Summary (PCS) and Mental Component Summary (MCS) (p = 0.005 and p = 0.011 for PCS; p = 0.008 and p = 0.025 for MCS, respectively) at second and third months follow-up. Additionally, ULR was significant better in Group 2 at second and third month of surgery (p = 0.042, p = 0.037, respectively). All these parameters were comparable between groups after sixth and 12th months.</p><p><strong>Conclusions: </strong>PTNS can be safely applied to provide early continence in patients underwent eLRP. Due to improved functional outcomes, higher quality of life might be gained in early follow-up period.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"360-366"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Sex and Diagnosis With Symptoms and Illness Impact in Urologic Chronic Pelvic Pain; A Mapp Network Analysis.","authors":"Bruce D Naliboff, Tara McWilliams, J Quentin Clemens, Michael A Pontari, Alisa J Stephens-Shields, Robert Moldwin, Siobhan Sutcliffe, Chris Mullins, J Richard Landis","doi":"10.1002/nau.25648","DOIUrl":"10.1002/nau.25648","url":null,"abstract":"<p><strong>Objective: </strong>To assess differences in clinical presentation and illness impact in men and women presenting with urologic chronic pelvic pain syndrome (UCPPS) and between men diagnosed with interstitial cystitis/bladder pain syndrome (IC/BPS) or chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).</p><p><strong>Methods: </strong>356 men and 605 women from six sites across the United States were assessed using a comprehensive set of demographic, symptom, and illness impact measures. Multivariable regression analyses examined differences between men and women and between men previously diagnosed with CP/CPPS or IC/BPS. In a stepwise manner, analyses tested group differences, controlling for demographic variables including symptom duration and presence of bladder pain that varied with filling and voiding.</p><p><strong>Results: </strong>Men diagnosed with IC/BPS had the most severe UCPPS symptoms, followed by women with IC/BPS, and then men with CP/CPPS only. While men and women showed similar patterns of symptoms across most of the variables, women had increased widespread non-pelvic pain, greater pelvic floor tenderness on exam, and higher self-reported sensory sensitivity compared to men. About 60% of men diagnosed with CP/CPPS only reported bladder symptoms of painful filling or relief with voiding.</p><p><strong>Conclusions: </strong>A generally shared symptom pattern was found across men and women irrespective of diagnostic labels suggesting the use of key marker symptoms, such as severity of bladder symptoms and widespread pain, to better identify subgroups of UCPPS rather than diagnostic category. Women may have an increased likelihood of increased sensitivity and central sensitization than men, including those men with IC/BPS.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02514265 - MAPP Research Network: Trans-MAPP Study of Urologic Chronic Pelvic Pain: Symptom Patterns Study (SPS).</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"400-408"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Overactive Bladder Therapy: Associations Between Clinical Care Pathways, Practice Guidelines, and Therapy Utilization Patterns.","authors":"Hodan Mohamud, Shada Sinclair, Susanna Gunamany, Claire S Burton, Chiyuan A Zhang, Raveen Syan, Ekene A Enemchukwu","doi":"10.1002/nau.25627","DOIUrl":"10.1002/nau.25627","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Overactive bladder (OAB) is a chronic condition with significant financial and health-related consequences. Guidelines and treatment pathways were created to optimize care and provide a clinical framework for diagnosing and managing OAB. However, the impact of these efforts and patterns of medical treatment for OAB are poorly understood. Therefore, we sought to evaluate overall trends in therapy utilization before and after the 2014 American Urological Association (AUA)/Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) OAB guideline amendment and publication of the OAB clinical care pathway in 2016.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective cohort study, we analyzed data from Optum, a national administrative health and pharmacy claims database, between 2013 and 2018. All adult patients diagnosed with idiopathic OAB were identified by the International Classification of Diseases 9th and 10th Revision codes. Oral OAB therapies were identified using National Drug Codes, while third-line therapy procedures, onabotulinumtoxinA (BTX), sacral neuromodulation (SNM), and percutaneous tibial nerve stimulation (PTNS), were identified using Current Procedural Terminology (CPT) codes. The study's primary outcome was the annual number of OAB prescriptions filled by pharmacotherapy class and the number of minimally invasive therapies performed during the study period. The secondary outcome was the association between OAB therapy utilization and various clinical and sociodemographic factors. Patterns of care were analyzed from 2013 to 2018, and initial treatment with each therapy was collected, excluding repeat procedures from the analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;1 825 782 patients were included in the study. The mean age was 61.1 ± 16.7 years, and 1 071 420 patients were female (58.7%). The number of new OAB diagnoses increased by 369% from 2013 to 2017. During the 6-year study period, 347 052 (19%) patients were treated with oral and/or third-line therapies. The overall number of oral medications prescribed peaked in 2016, followed by a 17% decline between 2016 and 2018. In 2013, the two most prescribed oral medications were oxybutynin (46%) and solifenacin (31.8%). By 2018, mirabegron (18.5%) surpassed solifenacin (16.5%), with oxybutynin still accounting for most prescriptions written (55%). Eighty percent of all initial mirabegron prescriptions were filled by patients over the age of 65. The rate of third-line therapy procedures almost doubled between 2013 and 2018 (9-17 procedures per 1000 OAB patients, p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Following the publication of the first OAB guidelines, there was an increase in OAB diagnoses, followed by a decrease in anticholinergic medication use, and a rise in beta-3 agonist utilization in patients over 65 years old. Additionally, there was greater adoption of third-line OAB therapies. These trends indicate that OA","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"319-329"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"The Association Between Different Levels of Depression and Overactive Bladder: A Cross-Sectional Study of the 2005-2018 National Health and Nutrition Examination Survey\" by Muwei Li et al.","authors":"Feng Jin, Yiqi Huang, Yanling Zhang, Liangyun Gao","doi":"10.1002/nau.25582","DOIUrl":"10.1002/nau.25582","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"522-523"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}