Can we create a valid treatment algorithm for patients with drug resistant overactive bladder (OAB) syndrome or detrusor overactivity (DO)? Results from a think tank (ICI-RS 2015)

被引:40
作者
Apostolidis, Apostolos [1 ]
Averbeck, Marcio Augusto [2 ]
Sahai, Arun [3 ,4 ]
Rahmana'i, Sajjad [5 ]
Anding, Ralf [6 ]
Robinson, Dudley [7 ]
Gravas, Stavros [8 ]
Dmochowski, Roger [9 ]
机构
[1] Aristotle Univ Thessaloniki, Dept Urol 2, Thessaloniki, Greece
[2] Moinhos de Vento Hosp, Dept Urol, Porto Alegre, RS, Brazil
[3] Guys Hosp, Dept Urol, London, England
[4] St Thomas Hosp, Dept Urol, London, England
[5] Maastricht Univ, Dept Urol, Maastricht, Netherlands
[6] Univ Hosp Bonn, Dept Neurourol, Bonn, Germany
[7] NHS Fdn Trust, Dept Urogynaecol, Kings Coll Hosp, London, England
[8] Univ Thessaly, Dept Urol, Larisa, Greece
[9] Vanderbilt Univ, Dept Urol, 221 Kirkland Hall, Nashville, TN 37235 USA
关键词
anticholinegics; antimuscarinics; augmentation cystoplasty; botulinum (neuro)toxin; detrusor myectomy; drug resistant; guidelines; management; neuromodulation; overactive bladder; percutaneous tibial nerve stimulation; refractory; treatment; urinary diversion; TIBIAL NERVE-STIMULATION; BOTULINUM-TOXIN-A; QUALITY-OF-LIFE; URGE URINARY-INCONTINENCE; SACRAL NEUROMODULATION; DOUBLE-BLIND; AUGMENTATION CYSTOPLASTY; ADULT PATIENTS; FOLLOW-UP; ONABOTULINUMTOXINA;
D O I
10.1002/nau.23170
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
AimsTo review and assess the definitions of drug resistance and the evidence supporting treatment for drug resistant overactive bladder/detrusor overactivity (OAB/DO). MethodsEvidence review of the extant literature and consensus of opinion was used to derive the summary recommendations. ResultsDrug resistance or drug refractory status has been inconsistently defined and reported in current evident sources. Recent publications use some correlation of lack of efficacy and or experienced side effects to define drug resistance. Algorithms based upon these definitions largely relate to the appropriate use of neuromodulation or botulinum neurotoxin, based upon patient selection and patient choice. Current treatment pathways are hampered by inability to consistently profile patients to optimize management, particularly after failure of initial pragmatic treatment. ConclusionsFurther research is recommended to better identify patient phenotype for purposes of directing optimized therapy for OAB/DO. Current treatment algorithms are influenced by extensive data generated from recent neuromodulation and botulinum neurotoxin trials.
引用
收藏
页码:882 / 893
页数:12
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