Exploring lifelong overactive bladder: Transitions, evidence, and clinical implications; A modified Delphi process.

Overactive bladder (OAB) is a prevalent urological condition characterized by urinary urgency, with or without urgency urinary incontinence, accompanied by increased daytime frequency and nocturia. However, the current definition of OAB lacks a specified time frame, hindering our understanding of the temporal aspects and transitions that occur within the OAB spectrum.

A modified Delphi study was conducted in three rounds, involving a panel of international experts in functional urology, urogynaecology, geriatrics, transitional medicine, and pediatric urology. The study took place between February 2023 and June 2023 and employed two sequential rounds of online surveys, followed by a final hybrid group discussion session in June 2023.

The Delphi process resulted in a consensus definition of lifelong OAB as a persistent and continuous condition that may manifest differently from birth and evolve over time, with varying levels of clinical perception. The course of its progression is influenced by transition periods and modifying factors, mainly anatomical, hormonal, and psychosocial/stressors. Three main transition periods were identified: achievement of daytime continence, adulthood to elderly, and transition to frail elderly. The panel also considered the therapeutic and diagnostic implications of lifelong OAB, as well as future research prospects in terms of importance and feasibility.

Future longitudinal research is needed to develop this concept and further identify transitions and temporal dynamics.

Neurourology and urodynamics. 2024 Jan 30 [Epub ahead of print]

George Bou Kheir, Irina Verbakel, Johan Vande Walle, Michel Wyndaele, Sanjay Sinha, Salvador Arlandis, Ann Raes, Paul Abrams, Alan Wein, François Hervé, Karel Everaert

Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium., Department of Paediatric Nephrology and Rheumatology, ERknet Center, Ghent University Hospital, Ghent, Belgium., Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands., Department of Urology, Apollo Hospital, Hyderabad, Telangana, India., Urology Department, La Fe University and Polytechnic Hospital, Valencia, Spain., Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium., Bristol Urological Institute, Southmead Hospital, Bristol, UK., Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA.