AUA Announces Update to its Overactive Bladder Clinical Practice Guideline

• Guideline Statement 12 was modified based upon a 2018 literature review, which uncovered a number of studies looking at combination therapy for the treatment of Overactive Bladder (OAB). These studies demonstrated improved efficacy with combination therapy without any significant effect on patient safety when compared to monotherapy.
  • Statement 12: Clinicians may consider combination therapy with an anti-muscarinic and β3-andrenoceptor agonist for patient refractory to monotherapy with either anti-muscarinics or β3-andrenoceptor agonists. (Option; Evidence Strength: Grade B)

• Guideline Statement 22 was re-categorized from “Additional Treatments” to “Fourth-Line Treatment.” No changes have been made to the text or associated discussion of this statement.
  • Statement 22: In rare cases, augmentation cystoplasty or urinary diversion for severe, refractory, complicated OAB patients may be considered. (Expert Opinion)

“This clinical framework for OAB does not require every patient go through each line of treatment in order, as there are many factors to consider when working with a patient to select the best treatment option,” said Sandip Prasan Vasavada, MD, guideline panel member and professor of surgery and urology at the Cleveland Clinic Foundation in Cleveland, Ohio. “This latest amendment to the guideline reflects recently published studies, including the success of using combination therapy to treat OAB and we are confident it is fully aligned with the latest science on treatments for patients with overactive bladder."