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PEER-TO-PEER CLINICAL CONVERSATIONS |
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| The Rise of FRU: How Functional Urology Intersects with Reconstructive Urology |
| Brian J. Flynn, MD |
| Brian Flynn discusses the emerging field of functional urology. Dr. Flynn defines functional urology as a comprehensive approach to non-cancer, non-stone, adult urological issues, focusing on restoring patients' functionality. Dr. Flynn highlights the upcoming International Functional and Reconstructive Urology Update conference as a step towards establishing this field, emphasizing its potential to improve patient care and professional recognition for urologists practicing in this area. |
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| Optimizing Overactive Bladder Treatment: Phenazopyridine's Cost-Effective Approach |
| Anjali Kapur, MD |
| Anjali Kapur discusses a cost analysis comparing oral Phenazopyridine (Pyridium) to intravesical lidocaine for pain control during Botox injections for overactive bladder. The study finds that using Pyridium is less costly, saving about $98 per visit and potentially $24 million annually if widely adopted. |
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AUA/SUFU Overactive Bladder Guidelines Emphasize Shared Decision-Making
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Ariana Smith, MD
Diane Newman interviews Ariana Smith about the newly released AUA/SUFU Overactive Bladder Guidelines. Dr. Smith, who co-chaired the guidelines, emphasizes the shift from a stepwise therapy approach to a patient-centered menu of treatment options.
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| COURAGE Trial: Vibegron for BPH Patients with Persistent OAB Symptoms |
| David Staskin, MD |
| David Staskin discusses the COURAGE trial, a phase three study evaluating the efficacy of Vibegron, a beta-3 adrenergic receptor agonist, in men with BPH and persistent OAB symptoms despite alpha-blocker treatment. The study demonstrates significant improvements in various urinary symptoms, including micturitions, urgency episodes, and nocturia. |
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| Oxybutynin-Associated Cognitive Impairment: Evidence and Implications for Overactive Bladder Treatment - Beyond the Abstract |
| Michael Chancellor, MD |
| Anticholinergic medications have long been mainstays of overactive bladder (OAB) treatment. Oxybutynin, a first-generation anticholinergic, still accounts for more than half of all OAB medication prescriptions, despite associations with impaired memory and cognition, as well as mounting evidence that it may increase the risk of incident dementia. |
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| Tibial Nerve Stimulation for Urge Urinary Incontinence and Overactive Bladder: Narrative Review of Randomized Controlled Trials and Applicability to Implantable Devices - Beyond the Abstract |
| Una J. Lee, MD, and Emily Gillespie, Ph.D. |
| Overactive bladder (OAB) is a highly prevalent condition affecting millions of people worldwide. Effective treatment options exist, yet there is a great deal of interest in additional safe and effective treatment options that meet the needs of our patients. Implantable tibial nerve stimulation (ITNS) is one innovative treatment option that is transforming the landscape of OAB. The high prevalence of OAB, the drive to expand treatment options, and the success of the tibial nerve as a therapeutic target led to the development of ITNS devices. |
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| Long-Term Dementia Risk with Use of Anticholinergic versus Beta-3-Agonist Pharmacotherapy for Overactive Bladder |
| David Sheyn, MD |
| David Sheyn presented a study examining the long-term dementia risk associated with anticholinergic versus beta-3-agonist medications for overactive bladder. The study found that, after adjusting for confounders, only the anticholinergic drug oxybutynin was linked to a 12% increased risk of dementia in women aged 65 and older, while in men, anticholinergic medications did not show an increased dementia risk. These findings highlight the need for further research into sex-based differences in dementia risk and overactive bladder etiology. |
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| Factors Influencing Medication Selection for Management of Overactive Bladder: Trends and Insights from AUA Quality Registry - Beyond the Abstract |
| Max Bowman, MD; Dora Jericevic, MD; Benjamin M Brucker, MD; and Michelle Van Kuiken, MD |
| A study analyzing the American Urological Association Quality Registry examined factors influencing the selection of β3 agonists versus anticholinergics for managing overactive bladder (OAB). It found that patients more likely to receive β3 agonists included those with private or military insurance, of white race, older than 50, and receiving care outside metropolitan or academic settings. These findings highlight disparities in OAB treatment choices, potentially influenced by insurance type, race, and healthcare setting. |
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