How effectively do we apply first-line treatment in overactive bladder?

Abstract

Introduction and hypothesisWe aimed to reveal the effectiveness of the combination of behavioral therapy (BT), drug therapy, and pelvic floor muscle training (PFMT) in patients with the diagnosis of overactive bladder (OAB) who did not respond to drug therapy. Methods Seventy female patients aged between 18 and 65 years diagnosed with wet-type OAB, who did not respond to drug therapy, were included in our study, which was planned as a prospective randomized controlled trial. The patients were randomly assigned to one of two groups. BT and a combination of anticholinergic + beta3-agonist was implemented in the control group for 12 weeks. BT and PFMT were applied with a combination of anticholinergic + beta3-agonist in the active therapy group for 12 weeks. Post-treatment changes in OAB, ICIQ-SF scores, and frequency and nocturia were compared. ResultsThe age and BMI averages of the groups were similar (p>0.01). After the treatment, no significant decrease was observed in OAB scores in the control group (p = 0.06), but a significant decrease was observed in the active therapy group (p<0.01). The mean ICIQ-SF scores and the number of nocturia were found to decrease in both groups after 12 weeks of treatment (p<0.01). There was no significant decrease in frequency in the control group (p = 0.054). It regressed significantly in the active therapy group (p<0.01). After the treatment, 3 of 30 the patients in control group (10%) and 11 of the 32 patients in the active therapy group (34.3%) said that their complaints had regressed and that they were pleased with their current situation. Although after the treatment, 4 patients in the control group were dry (13.3%), 10 patients in the active therapy group were dry (31.25%). Conclusions We demonstrated that drug therapy, BT, and PFMT, which are recommended in the first-line treatment of OAB reduce the need for invasive treatments when they are well explained to the patients and combined.

Use of a Digital Conversational Agent for the Management of Overactive Bladder

“…13 A comprehensive approach to help patients understand the nature of OAB and implement behavioral therapies has been shown to lead to better adherence and improved outcomes. 14 Over the past several years, several studies have demonstrated the efficacy of digital therapeutics for the treatment of urinary incontinence; with several demonstrating improved adherence. [15][16][17] However, these studies predominantly focus on biofeedback therapy, and the vast majority of patients were those with stress urinary incontinence.…”

“…Treatment adherence is significantly lower in the clinical setting compared with the research setting, possibly due to differences in patient engagement and health care professional time constraints, which affect the ability to adequately counsel patients in the clinical setting compared with research setting 13 . A comprehensive approach to help patients understand the nature of OAB and implement behavioral therapies has been shown to lead to better adherence and improved outcomes 14 …”