Journal article
Treatment patterns in women with urinary urgency and/or urgency urinary incontinence in the symptoms of Lower Urinary Tract Dysfunction Research Network Observational Cohort Study
Neurourology and urodynamics, Vol.42(1), pp.194-204
01/2023
DOI: 10.1002/nau.25067
PMID: 36579974
Abstract
Background Limited epidemiological data exist describing how patients engage with various treatments for overactive bladder (OAB). To improve care for patients with OAB, it is essential to gain a better understanding of how patients interface with OAB treatments longitudinally, that is, how often patients change treatments and the pattern of this treatment change in terms of escalation and de-escalation. Objectives To describe treatment patterns for women with bothersome urinary urgency (UU) and/or urgency urinary incontinence (UUI) presenting to specialty care over 1 year. Study Design The Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) study enrolled adult women with bothersome UU and/or UUI seeking care for lower urinary tract symptoms (LUTS) between January 2015 and September 2016. An ordinal logistic regression model was fitted to describe the probabilities of escalating or de-escalating level of treatment during 1-year follow-up. Results Among 349 women, 281 reported UUI and 68 reported UU at baseline. At the end of 1 year of treatment by a urologist or urogynecologist, the highest level of treatment received by participants was 5% expectant management, 36% behavioral treatments (BT), 26% physical therapy (PT), 26% OAB medications, 1% percutaneous tibial nerve stimulation, 3% intradetrusor onabotulinum toxin A injection, and 3% sacral neuromodulation. Participants using BT or PT at baseline were more likely to be de-escalated to no treatment than participants on OAB medications at baseline, who tended to stay on medications. Predictors of the highest level of treatment included starting level of treatment, hypertension, UUI severity, stress urinary incontinence, and anticholinergic burden score. Conclusions Treatment patterns for UU and UUI are diverse. Even for patients with significant bother from OAB presenting to specialty clinics, further treatment often only involves conservative or medical therapies. This study highlights the need for improved treatment algorithms to escalate patients with persistent symptoms, or to adjust care in those who have been unsuccessfully treated.
Details
- Title: Subtitle
- Treatment patterns in women with urinary urgency and/or urgency urinary incontinence in the symptoms of Lower Urinary Tract Dysfunction Research Network Observational Cohort Study
- Creators
- Carol Emi Bretschneider - Northwestern UniversityQian Liu - Arbor Research Collaborative for HealthAbigail R. Smith - Arbor Research Collaborative for HealthZiya Kirkali - NIDDK, Bethesda, MD 20892 USACindy L. Amundsen - Duke Medical CenterHenry Lai - Washington University in St. LouisJuila Geynisman-Tan - Northwestern UniversityAnna Kirby - University of Washington Medical CenterAnne P. Cameron - University of MichiganMargaret E. Helmuth - Arbor Research Collaborative for HealthJames W. Griffith - Northwestern UniversityJohn Eric Jelovsek - Duke Medical CenterSymptoms Lower Urinary Tract Dysfu
- Resource Type
- Journal article
- Publication Details
- Neurourology and urodynamics, Vol.42(1), pp.194-204
- DOI
- 10.1002/nau.25067
- PMID
- 36579974
- NLM abbreviation
- Neurourol Urodyn
- ISSN
- 0733-2467
- eISSN
- 1520-6777
- Publisher
- Wiley
- Number of pages
- 11
- Grant note
- National Institutes of Health National Center for Advancing Translational Sciences National Institute of Diabetes and Digestive and Kidney Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) U01DK099932 / National Institute of Diabetes and Digestive and Kidney Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
- Language
- English
- Date published
- 01/2023
- Academic Unit
- Urology
- Record Identifier
- 9985244664602771
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