SCOTTSDALE, AZ USA (UroToday.com) - Drs. Michelle Koski and Larry Sirls, II moderated a poster session for “LUTS/Voiding Dysfunction/Neurogenic Bladder”. Notable abstracts were:
Outcomes after midurethral sling (MUS) placement in women with stress urinary incontinence and concomitant severe lower urinary tract symptoms (Presented by Marisa Clifton, MD).
The purpose of their prospective trial was to assess the outcomes in patients with both stress urinary incontinence and severe obstructive symptoms (AUA Symptom Score >20) and/or evidence of obstruction on urodynamics. Patients were followed for a mean of 31.5 months. All patients had a significant improvement in storage and voiding symptoms after MUS. No patient experienced urinary retention postoperatively. The improvements were durable on follow-up validated surveys. They feel their data supports the safety and efficacy of MUS in patients with stress urinary incontinence and concomitant obstructive symptoms.
Fesoterodine 8mg sersus fesoterodine 4mg in patients with overactive bladder and a history of previous antimuscarinic therapy: Results from the Eight trial (Presented by Christopher Chapple, BSc, MD, FRCS, FEBU).
The authors present their ad hoc analysis of the EIGHT trial (a 12-week, double-blinded, placebo controlled, randomized controlled trial) comparing fesoterodine 8mg to 4mg. The ad hoc analysis assessed the efficacy in patients who has previously failed other anticholinergics (71% of patients). At week 12, fesoterodine 8mg significantly improved urge urinary incontinence episodes (-3.2 v -2.8. Placebo -1.8), health related quality of life, micturations (-2.8 v -2.1. Placebo -1.0), and diary dry rate (59.8% v 42.8%. Placebo 34.6%) as compared to 4mg dosing. However, the higher dosing also had significantly higher rates of dry mouth (24% v. 10%. Placebo 3%) and constipation (4% v. 1%. Placebo 2%). The authors concluded that the data supports the additional efficacy of 8mg as opposed to 4mg dosing.
Consistent long-term efficacy and safety of repeat onabotulinumtoxinA injections in patients with neurogenic detrusor overactivity: Final results of up to 4 years’ treatment (Presented by Courtenay Moore, MD).
The authors report the 4-year follow up results of a multicenter study assessing the efficacy of repeated BOTOX® injections for the treatment of urge urinary incontinence in patients with neurogenic detrusor overactivity. Patients were injected with 200 or 300 units. Patients were retreated, as needed, based upon patient request. Almost 61% of the initial 396 patients were followed for more than 4 years, making this the longest reported follow up of BOTOX® patients. Three percent of patients discontinued treatment due to adverse event. Two percent discontinued for lack of efficacy. For the 200 units group, de novo CIC rates declined from 29.5% to 6.0% after injections 1 to 3 and 0% for injections 4 to 6. BOTOX® consistently improved the mean urinary incontinence episodes/per day -3.2 to -4.1 over six treatments. The authors conclude that the success of BOTOX® injections is consistent over time without an increase in adverse events after multiple injections.
Moderated by Michelle Koski, MD and Larry Sirls, II, MD at the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) Winter Meeting - February 24 - 28, 2015 - JW Marriott Camelback Inn Resort & Spa - Scottsdale, AZ USA
Reported for UroToday by Drew Freilich, MD. Dr. Freilich is a graduate of the University of Massachusetts Medical School and completed his urology residency at New York Medical College/Westchester Medical Center. He is currently a fellow in Female Urology, Neurourology and Reconstructive Urology at Medical University of South Carolina. He has authored more than 40 peer-reviewed articles, monographs, abstracts, and book chapters and abstracts. Dr. Freilich is a member of the American Urological Association and the Society for Urodynamics and Female Urology.