Topic: Overactive Bladder

Overactive Bladder (OAB) / Urge Urinary Incontinence (UUI) & the Urinary Microbiome

Nazema Y. Siddiqui, MD, MHSc, Associate Professor of Obstetrics & Gynecology at Duke University, discusses studies that investigate the urinary microbiome and its links to overactive bladder (OAB) and urge urinary incontinence (UUI). She specifically identifies BMI, age, and estrogen levels as leading potential variables for predicting a patient’s urinary microbiome, and posits that longitudinal studies and computational models to better understand the microbiome will be necessary to make this knowledge useful for treatment and diagnosis of OAB and UUI in the future.

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Geriatric Considerations in Urinary Incontinence and Overactive Bladder (OAB)

Una Lee, MD, FPMRS, a urologist at the Virginia Mason Medical Center, discusses concepts physicians should consider when managing urinary incontinence and overactive bladder (OAB) in geriatric populations. First, Dr. Lee reviews the “5 M’s”: mind, mobility, medications, multi-complexity, and what matters most to the patient, or care goals/preferences. Additionally, she addresses the role of frailty in older adults, which is associated with increased risk of poor health outcomes. Lastly, she reviews data about the association of anticholinergic medication use and dementia.

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Management of the Advanced OAB Patient

Christopher P. Smith, MD, MBA, MSS, describes the treatment pathway for advanced overactive bladder (OAB) patients as described in the American Urological Association (AUA)/ Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) OAB guidelines. He discusses novel treatment approaches, including rechargeable sacral neuromodulation devices, implantable tibial nerve stimulators, bladder denervation, and transcutaneous stimulation of the tibial nerves.

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