A preliminary study on the impact of detrusor overactivity on the efficacy of selective bladder denervation for the treatment of female refractory overactive bladder.

Abstract

OBJECTIVES\nTo determine whether the presence of detrusor overactivity (DO) is associated with the 12-week and 12-month clinical outcomes of selective bladder denervation (SBD) in women with refractory overactive bladder (OAB).\n\n\nMETHODS\nProspective single institutional study of refractory OAB females who underwent a urodynamic study (UDS) and were categorized according to DO status (DO- vs. DO+) prior to receiving SBD.\n\n\nRESULTS\nAmong the 23 patients, 10 were DO- and 13 were DO+. Both groups reported improvement at 12 weeks on the 24-hour pad weight test (PWT), urgency urinary incontinence (UUI) and urgency. At 12 months, both groups still reported improvement in urgency, but only the DO- group reported reduction on the PWT and only the DO+ group maintained improvement on the UUI rate. Clinical success (≥ 50% reduction in UUI) was achieved by all DO- and by 69% of DO+ patients at 12 weeks, and by 60% of DO- and 92% of DO+ patients at 12 months. Treatment benefit (Treatment Benefit Scale ≤ 2) was reported in 90% of DO- and 85% of DO+ patients at 12 weeks, and in 60% of DO- and 85% of DO+ patients at 12 months. When directly comparing both group outcomes, the only significant difference was the greater reduction of UUI in the DO- group at 12 weeks (-9.0 vs. -6.5; p=0.045).\n\n\nCONCLUSIONS\nRefractory OAB females appear to be effectively treated by SBD regardless of baseline DO status. DO status does not seem to be associated with the 12-week and 12-month outcomes of SBD.