Pd59-01 Outcomes of Sequential Third-Line Therapies in Patients With Refractory Overactive Bladder

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neuromodulation (PD59)1 May 2024PD59-01 OUTCOMES OF SEQUENTIAL THIRD-LINE THERAPIES IN PATIENTS WITH REFRACTORY OVERACTIVE BLADDER Po-Ming Chow and Howard Goldman Po-Ming ChowPo-Ming Chow and Howard GoldmanHoward Goldman View All Author Informationhttps://doi.org/10.1097/01.JU.0001009544.34256.8a.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Sacral neuromodulation (SNM) and onobotulinumtoxinA (BoNTA) injection are third-line therapies for overactive bladder (OAB). Although the efficacy of each third-line treatment has been well established in clinical trials, there is far less information about performing one third-line therapy after the other. We investigate the outcomes of post-SNM BoNTA and post-BoNTA SNM as "second" third-line treatments. METHODS: We retrospectively reviewed OAB patients who had both SNM and BoNTA between 2013 and 2022. The primary endpoint was the response rates (>50% improvements) of the second third-line treatments. Secondary endpoints were the proportion of the patients who achieved total dry, the duration of treatment of patients who had significant responses, and risk factors that are associated with treatment response or duration of treatments. RESULTS: A total of 172 patients had two third-line therapies. There were 104 patients who had post-SNM BoNTA and 68 patients who had post-BoNTA SNM. In the post-SNM BoNTA group, 62.5% had significant responses after BoNTA treatment. In the post-BoNTA SNM group, 61.8% had significant responses after SNM treatment. The proportions of patients who became dry were 21.2% and 23.5%, respectively. In the post-SNM BoNTA group, spinal pathology is associated with less probability of a significant response (48.9% vs. 73.7%, p-value=0.0105). More than 50% of patients remained on the same therapy at 5-year follow-up. CONCLUSIONS: Patients with refractory OAB who have failed BoNTA or SNM have the potential for favorable outcomes when switched over to the other therapy. Spinal pathology is associated with a poorer response of post-SNM BoNTA. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1221 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Po-Ming Chow More articles by this author Howard Goldman More articles by this author Expand All Advertisement PDF downloadLoading ...