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A Preliminary Study on the Impact of Detrusor Overactivity on the Efficacy of Selective Bladder Denervation for the Treatment of Female Refractory Overactive Bladder

  • Raphaëlle Brière
    Affiliations
    Faculty of Medicine, Université Laval, Québec, Québec, Canada
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  • Eboo Versi
    Affiliations
    Department of Obstetrics, Gynecology, Reproductive Sciences, Rutgers, New Brunswick, NJ
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  • Patrick O. Richard
    Affiliations
    Division of Urology, Department of Surgery, Faculty of Medicine and Health Sciences, Centre Hospitalier Universitaire de Sherbrooke and Centre de Recherche du CHUS, Sherbrooke, Québec, Canada
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  • Matthieu Gratton
    Affiliations
    Division of Urology, Department of Surgery, Faculty of Medicine, CHU de Québec-Université Laval, Québec, Québec, Canada
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  • Le Mai Tu
    Correspondence
    Address correspondence to: Le Mai Tu, M.D., F.R.C.S.C., M.Sc., Division of Urology, Departments of Surgery, Faculty of Medicine and Health Sciences, Centre Hospitalier Universitaire de Sherbrooke and Centre de Recherche du CHUS, 3001, 12ieme avenue N, Sherbrooke, Québec J1H 5N4, Canada.
    Affiliations
    Division of Urology, Department of Surgery, Faculty of Medicine and Health Sciences, Centre Hospitalier Universitaire de Sherbrooke and Centre de Recherche du CHUS, Sherbrooke, Québec, Canada
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Published:November 30, 2019DOI:https://doi.org/10.1016/j.urology.2019.08.061

      ABSTRACT

      Objective

      To 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).

      Methods

      Prospective single institutional study of refractory OAB females who underwent a urodynamic study and were categorized according to DO status (DO− vs DO+) prior to receiving SBD.

      Results

      Among the 23 patients, 10 were DO− and 13 were DO+. Both groups reported improvement at 12 weeks on the 24-hour pad weight test, in 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 pad weight test and only the DO+ group maintained improvement in 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 = .045).

      Conclusion

      Refractory 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.
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