To determine whether the presence of detrusor overactivity (DO) is associated with the 12-week and 12-month clinical outcomes of selective bladder denervation (SBD) in women with refractory overactive bladder (OAB).
Prospective single institutional study of refractory OAB females who underwent a urodynamic study (UDS) and were categorized according to DO status (DO- vs. DO+) prior to receiving SBD.
Among the 23 patients, 10 were DO- and 13 were DO+. Both groups reported improvement at 12 weeks on the 24-hour pad weight test (PWT), urgency urinary incontinence (UUI) and urgency. At 12 months, both groups still reported improvement in urgency, but only the DO- group reported reduction on the PWT and only the DO+ group maintained improvement on the UUI rate. Clinical success (≥ 50% reduction in UUI) was achieved by all DO- and by 69% of DO+ patients at 12 weeks, and by 60% of DO- and 92% of DO+ patients at 12 months. Treatment benefit (Treatment Benefit Scale ≤ 2) was reported in 90% of DO- and 85% of DO+ patients at 12 weeks, and in 60% of DO- and 85% of DO+ patients at 12 months. When directly comparing both group outcomes, the only significant difference was the greater reduction of UUI in the DO- group at 12 weeks (-9.0 vs. -6.5; p=0.045).
Refractory OAB females appear to be effectively treated by SBD regardless of baseline DO status. DO status does not seem to be associated with the 12-week and 12-month outcomes of SBD.
Urology. 2019 Nov 30 [Epub ahead of print]
Raphaëlle Brière, Eboo Versi, Patrick O Richard, Matthieu Gratton, Le Mai Tu
Faculty of Medicine, Université Laval, Québec, Québec, Canada. Electronic address: ., Department of Obstetrics, Gynecology, Reproductive Sciences, Rutgers, New Brunswick, NJ, United States.. Electronic address: ., Division of Urology, Department of Surgery, Faculty of Medicine and Health Sciences, Centre Hospitalier Universitaire de Sherbrooke and Centre de Recherche du CHUS, Sherbrooke, Québec, Canada.. Electronic address: ., Division of Urology, Department of Surgery, Faculty of Medicine, CHU de Québec-Université Laval, Québec, Québec, Canada.. Electronic address: ., Division of Urology, Department of Surgery, Faculty of Medicine and Health Sciences, Centre Hospitalier Universitaire de Sherbrooke and Centre de Recherche du CHUS, Sherbrooke, Québec, Canada.. Electronic address: .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/31794815