OBJECTIVES: Overactive bladder (OAB) is a pathology impairing patients' quality of life and with a high percentage of patients who are refractory to medication.
In this paper, technical opinion of an «expert panel» is assessed in order to gain the most reliable professional consensus on scientific evidence available on the criteria of use of Onabotulinumtoxin A (OnabotA) in OAB.
MATERIAL AND METHODS: According to DELPHI method, 42 panelists answered a survey of 93 items divided into four strategic areas including clinical criteria and recommendations in order to improve, at different levels, the current approach to patients with OAB. The recent advances in the field, areas of controversy and their real application possibilities in the different areas of our health care system were taken into consideration.
RESULTS: Two rounds of the questionnaire were completed by all experts. In the first round, a criteria consensus was reached for 64 of 93 (68.8%) questions analyzed; in the second round the consensus reached was for 83 items evaluated (89.25%). An agreement among panelist was reached for: 1) definition, classification, detection and differential diagnosis; 2) medical treatment; 3) surgical treatment; 4) role of OnabotA in the treatment of OAB.
CONCLUSIONS: The consensus is broadly in line with the latest scientific evidence on OAB. The panelists believe that it is necessary to propose a change in the current definition of OAB and that it seems necessary to improve the screening tools too. Medical treatment of OAB must be tailored to each patient, staged and progressive. The use of OnabotA (Botox®) could imply therapeutic advantages with respect to other treatments, and positions itself as a safe and effective alternative to treat drug refractory OAB.
Written by:
Esteban M, Salinas J, Arlandis S, Díez J, Jiménez M, Rebassa M, Angulo JC. Are you the author?
Servicio de Urología, Hospital Nacional de Parapléjicos, Toledo, España; Servicio de Urología, Hospital Clínico San Carlos, Universidad Complutense, Madrid, España; Servicio de Urología, Hospital Universitario y Politécnico La Fe, Valencia, España; Servicio de Urología, Hospital Universitario Infanta Sofía, Madrid, España; Servicio de Urología, Hospital Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, España; Servicio de Urología, Hospital Son Llàtzer, Palma de Mallorca, España; Servicio de Urología, Hospital Universitario de Getafe, Universidad Europea de Madrid, Madrid, España.
Reference: Actas Urol Esp. 2014 Jan 14. pii: S0210-4806(13)00419-1.
doi: 10.1016/j.acuro.2013.12.002
PubMed Abstract
PMID: 24439057
UroToday.com Overactive Bladder (OAB) Section
