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Current Bladder Dysfunction Reports

, Volume 13, Issue 3, pp 158–161 | Cite as

Does Urodynamics Impact the Outcomes of Third-line Therapy of Refractory OAB (or Refractory Urgency Urinary Incontinence)?

  • Marc P. Schneider
  • Andrea Tubaro
  • Fiona C. Burkhard
Overactive Bladder and Lower Urinary Tract Symptoms (U Lee and S Adelstein, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Overactive Bladder and Lower Urinary Tract Symptoms

Abstract

Purpose of Review

Overactive bladder (OAB) is highly prevalent with increasing age. Conservative management including lifestyle adaptation, controlled fluid intake, and bladder training are considered first-line therapeutic options. Second-line options are medication such as antimuscarinics or beta-3 adrenergic receptor agonists. Therapy refractory patients should be referred to a specialist for further evaluation.

Recent Findings

It currently remains unclear if patients should undergo routine urodynamic investigation (UDI) before offering third-line therapies like sacral neuromodulation (SNM) or intradetrusor injection of onabotulinumtoxinA (IdetInBotA). The aim of this narrative review was to assess if the presence of detrusor overactivity (DO) can predict treatment success of third-line therapies for OAB.

Summary

There is only limited evidence available for both IdetInBotA and SNM, but treatment success does not appear to be related to the presence of DO in baseline UDI. Hence, routine UDI is not mandatory in patients with OAB but remains an option when its outcome is likely to change the treatment strategy or to assess the risk of upper urinary tract deterioration.

Keywords

Detrusor overactivity Overactive bladder Neuromodulation therapy Sacral neuromodulation Intradetrusor injection of onabotulinumtoxinA 

Notes

Compliance with Ethical Standards

Conflict of Interest

Marc P. Schneider, Andrea Tubaro, and Fiona C. Burkhard declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Marc P. Schneider
    • 1
  • Andrea Tubaro
    • 2
  • Fiona C. Burkhard
    • 1
  1. 1.Department of Urology, InselspitalUniversity of BernBernSwitzerland
  2. 2.Department of Urology, Sant’Andrea HospitalSapienza University of RomeRomeItaly

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