An Update in the Treatment of Overactive Bladder/Urge Urinary Incontinence-OAB Handouts

OAB Handouts

Pdf Summary

The document titled "An Update in the Treatment of OAB/UUI" discusses the clinical continuum of overactive bladder (OAB) symptoms and various treatment options. OAB is characterized by urgency, with or without urinary incontinence, and is often accompanied by increased daytime frequency and nocturia. The document highlights the prevalence of OAB and its impact on quality of life.<br /><br />The pathogenesis of OAB is discussed, including theories related to neurogenic, myogenic, autonomous bladder, and afferent signal dysregulation. The document also outlines the distribution of cholinergic and adrenergic receptors in the bladder and urethra, which play a role in bladder function and emptying.<br /><br />Current treatments for OAB include medications, behavioral therapies, electronic stimulation, neuromodulation, and botulinum toxin A injections. The document provides an overview of the various medication options, including anticholinergics, β3 agonists, and combination therapies. It also discusses the potential risks and side effects associated with these medications.<br /><br />Advances in OAB treatment are explored, including new medications under clinical trials such as tarafenacin, afacifenacin, solabegron, and ritobegron. Other treatment modalities, such as vaginal electrical stimulation and posterior tibial nerve stimulation, are also discussed.<br /><br />Neuromodulation options, including the use of rechargeable and non-rechargeable sacral neuromodulation systems, are highlighted. The document compares the advantages of Axonics and Medtronic systems in terms of battery life, size, and functionality.<br /><br />Lastly, the document mentions "new horizon" investigational medications that target specific enzymes, ion channels, and miscellaneous targets. These include sodium nitroprusside, sildenafil, tadalafil, Y-27632, pregabalin, and URO-902.<br /><br />Overall, the document provides a comprehensive overview of the current understanding of OAB and its treatment options.

Keywords

OAB/UUI

overactive bladder

urinary incontinence

daytime frequency

nocturia

cholinergic receptors

adrenergic receptors

medications

behavioral therapies

neuromodulation