Clinical Pathways of Third-Line Treatment of Overactive Bladder in the Elderly

Bilal Farhan, Gamal Ghoniem

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Overactive bladder (OAB) is a syndrome of urinary urgency, usually accompanied by frequency, nocturia, and sometimes urinary urgency incontinence. There are many guidelines for the OAB treatment which are constructed on a stepwise fashion starting from the least invasive to the more invasive therapy. The emergence of third-line therapy (AUA/SUFU guidelines) has resulted in significant decrease of more invasive surgery and improved patients’ quality of life. The aim of a clinical pathway is to improve the quality of care, reduce risks, increase patient satisfaction, and increase the efficiency in the use of resources. The available options for the third-line OAB treatments include intravesical injection of botulinum toxin A, percutaneous tibial nerve stimulation (PTNS), and sacral nerve stimulation (SNS). The available evidence confirms that all three treatment approaches are well tolerated and effective, although only botulinum toxin type A (BoNTA) and SNS can achieve nearly a cure of urgency urinary incontinence (UUI). The choice among the different third-line treatment depends on patient preference, availability, and local expertise. The application of these pathways can improve incontinence care by letting physicians adequately communicate with patients and select individualized therapy at an early stage especially for elderly patients.

Original languageEnglish (US)
Pages (from-to)381-390
Number of pages10
JournalCurrent Bladder Dysfunction Reports
Volume10
Issue number4
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

Fingerprint

Overactive Urinary Bladder
Type A Botulinum Toxins
Critical Pathways
Surgery
Availability
Urinary Incontinence
Therapeutics
Guidelines
Intravesical Administration
Nocturia
Tibial Nerve
Patient Preference
Quality of Health Care
Patient Satisfaction
Quality of Life
Physicians

Keywords

  • Clinical pathways
  • Onabotulinum toxin A
  • Overactive bladder
  • Percutaneous tibial nerve stimulation
  • Sacral neuromodulation
  • Third line treatment

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Biology

Cite this

Clinical Pathways of Third-Line Treatment of Overactive Bladder in the Elderly. / Farhan, Bilal; Ghoniem, Gamal.

In: Current Bladder Dysfunction Reports, Vol. 10, No. 4, 01.12.2015, p. 381-390.

Research output: Contribution to journalReview article

@article{712ced7db80d4482b65c6cec4f337b4f,
title = "Clinical Pathways of Third-Line Treatment of Overactive Bladder in the Elderly",
abstract = "Overactive bladder (OAB) is a syndrome of urinary urgency, usually accompanied by frequency, nocturia, and sometimes urinary urgency incontinence. There are many guidelines for the OAB treatment which are constructed on a stepwise fashion starting from the least invasive to the more invasive therapy. The emergence of third-line therapy (AUA/SUFU guidelines) has resulted in significant decrease of more invasive surgery and improved patients’ quality of life. The aim of a clinical pathway is to improve the quality of care, reduce risks, increase patient satisfaction, and increase the efficiency in the use of resources. The available options for the third-line OAB treatments include intravesical injection of botulinum toxin A, percutaneous tibial nerve stimulation (PTNS), and sacral nerve stimulation (SNS). The available evidence confirms that all three treatment approaches are well tolerated and effective, although only botulinum toxin type A (BoNTA) and SNS can achieve nearly a cure of urgency urinary incontinence (UUI). The choice among the different third-line treatment depends on patient preference, availability, and local expertise. The application of these pathways can improve incontinence care by letting physicians adequately communicate with patients and select individualized therapy at an early stage especially for elderly patients.",
keywords = "Clinical pathways, Onabotulinum toxin A, Overactive bladder, Percutaneous tibial nerve stimulation, Sacral neuromodulation, Third line treatment",
author = "Bilal Farhan and Gamal Ghoniem",
year = "2015",
month = "12",
day = "1",
doi = "10.1007/s11884-015-0341-4",
language = "English (US)",
volume = "10",
pages = "381--390",
journal = "Current Bladder Dysfunction Reports",
issn = "1931-7212",
publisher = "Current Medicine Group",
number = "4",

}

TY - JOUR

T1 - Clinical Pathways of Third-Line Treatment of Overactive Bladder in the Elderly

AU - Farhan, Bilal

AU - Ghoniem, Gamal

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Overactive bladder (OAB) is a syndrome of urinary urgency, usually accompanied by frequency, nocturia, and sometimes urinary urgency incontinence. There are many guidelines for the OAB treatment which are constructed on a stepwise fashion starting from the least invasive to the more invasive therapy. The emergence of third-line therapy (AUA/SUFU guidelines) has resulted in significant decrease of more invasive surgery and improved patients’ quality of life. The aim of a clinical pathway is to improve the quality of care, reduce risks, increase patient satisfaction, and increase the efficiency in the use of resources. The available options for the third-line OAB treatments include intravesical injection of botulinum toxin A, percutaneous tibial nerve stimulation (PTNS), and sacral nerve stimulation (SNS). The available evidence confirms that all three treatment approaches are well tolerated and effective, although only botulinum toxin type A (BoNTA) and SNS can achieve nearly a cure of urgency urinary incontinence (UUI). The choice among the different third-line treatment depends on patient preference, availability, and local expertise. The application of these pathways can improve incontinence care by letting physicians adequately communicate with patients and select individualized therapy at an early stage especially for elderly patients.

AB - Overactive bladder (OAB) is a syndrome of urinary urgency, usually accompanied by frequency, nocturia, and sometimes urinary urgency incontinence. There are many guidelines for the OAB treatment which are constructed on a stepwise fashion starting from the least invasive to the more invasive therapy. The emergence of third-line therapy (AUA/SUFU guidelines) has resulted in significant decrease of more invasive surgery and improved patients’ quality of life. The aim of a clinical pathway is to improve the quality of care, reduce risks, increase patient satisfaction, and increase the efficiency in the use of resources. The available options for the third-line OAB treatments include intravesical injection of botulinum toxin A, percutaneous tibial nerve stimulation (PTNS), and sacral nerve stimulation (SNS). The available evidence confirms that all three treatment approaches are well tolerated and effective, although only botulinum toxin type A (BoNTA) and SNS can achieve nearly a cure of urgency urinary incontinence (UUI). The choice among the different third-line treatment depends on patient preference, availability, and local expertise. The application of these pathways can improve incontinence care by letting physicians adequately communicate with patients and select individualized therapy at an early stage especially for elderly patients.

KW - Clinical pathways

KW - Onabotulinum toxin A

KW - Overactive bladder

KW - Percutaneous tibial nerve stimulation

KW - Sacral neuromodulation

KW - Third line treatment

UR - http://www.scopus.com/inward/record.url?scp=84946037178&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946037178&partnerID=8YFLogxK

U2 - 10.1007/s11884-015-0341-4

DO - 10.1007/s11884-015-0341-4

M3 - Review article

AN - SCOPUS:84946037178

VL - 10

SP - 381

EP - 390

JO - Current Bladder Dysfunction Reports

JF - Current Bladder Dysfunction Reports

SN - 1931-7212

IS - 4

ER -