6-month Results of Selective Bladder Denervation in Women with Refractory Overactive Bladder

To report 6-month efficacy and safety outcomes with selective bladder denervation in women with refractory OAB.

Women with refractory OAB and UUI were enrolled in two prospective feasibility studies with the same entry criteria and received selective bladder denervation of the sub-trigonal region containing afferent sensory nerves. Patients were followed for 6 months and assessed for adverse events, OAB symptoms, and health-related quality of life measures.

Among 35 women (mean age 66 years) enrolled in the study, all selective bladder denervation procedures were completed successfully. Over 6 months follow-up, symptom improvement based on 3-day bladder diaries was 59% for UUI (p<0.001), 59% for UI (p<0.001), 39% for urgency (p<0.001), 9% for urinary frequency (p=0.01), and 27% for the total urgency and frequency score (p<0.001), with the majority of this treatment benefit realized in the first month. Clinical success (≥50% reduction in UUI) was 70%, treatment benefit was reported in 75% of patients, and the dry/cure rate was 27%. Statistically significant improvements over 6 months were identified on Symptom Bother and Health-related Quality of Life scales on the OAB-q, and on all KHQ domains except General Health Perception. Device- or procedure-related adverse events were reported in 6 (17%) patients.

Pooled results of two prospective feasibility studies suggest that selective bladder denervation is a promising minimally invasive treatment option for women with refractory OAB.

The Journal of urology. 2018 Sep 18 [Epub ahead of print]

Stefan De Wachter, Kevin D Benson, Roger R Dmochowski, Eric S Rovner, Eboo Versi, Larry E Miller, Le Mai Tu

Department of Urology, Antwerp University Hospital and Faculty of Medicine, University of Antwerp, Antwerp, Belgium., Sanford Health, Sioux Falls, SD, United States., Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, United States., Department of Urology, Medical University of South Carolina, Charleston, SC, United States., Department of Obstetrics, Gynecology, Reproductive Sciences, Rutgers, New Brunswick, NJ, United States., Miller Scientific Consulting, Asheville, NC, United States. Electronic address: ., Division of Urology, Department of Surgery, Sherbrooke University Hospital, Sherbrooke, QC, Canada.