Treatment for refractory overactive bladder: what do women want?

  • Research type

    Research Study

  • Full title

    The patient experience of Percutaneous Tibial Nerve Stimulation vs Intravesical Botulinum Toxin A injections for Refractory Overactive Bladder.

  • IRAS ID

    333882

  • Contact name

    Rayan Mohamed-ahmed

  • Contact email

    r.mohamed-ahmed@nhs.net

  • Sponsor organisation

    King’s College London

  • Duration of Study in the UK

    0 years, 8 months, 4 days

  • Research summary

    Refractory overactive bladder (OAB), a term used to describe OAB symptoms that do not respond to initial treatment, lacks formal definition and is poorly understood.

    First line treatment for women with OAB includes lifestyle advice and fluid adjustment, supervised pelvic floor muscle therapy (PFMT), bladder training and anti-cholinergic medication. It is estimated that anticholinergic medications do not provide satisfactory improvement in symptoms in around 25-40% of patients. These patients then require second line treatment, following discussion at Urogynaecology or Urology multi-disciplinary team meetings.

    Second line treatment includes intra-vesical Botulinum toxin injections, sacral nerve stimulation and percutaneous tibial nerve stimulation (PTNS). Surgical treatments, following failed second line treatment, includes urinary diversion or augmentation cystoplasty.

    Data regarding continuation with second line therapy for OAB treatment are scarce. This study aims to understand factors that influence a patient’s choice of second line therapy and the reasons for continuation vs discontinuation with treatment. We are aiming to do this by conducting focus group discussions, where patients are able to discuss their opinions regarding treatment and what their expectations of second line treatment are.

    Eligible patients for the study are patients who have trialled management with second line therapy for OAB i.e. PTNS or intravesical botox. This study will be conducted in a Urogynaecology Department in a Tertiary Hospital. The patients are expected to attend one focus group discussion, which may take 1.5 to 2 hours.

    Further understanding into this area will improve patient counselling prior to initiation of invasive treatments, allow patients to make more informed choice regarding their treatment and improve satisfaction and continuation rates.

  • REC name

    West Midlands - Black Country Research Ethics Committee

  • REC reference

    24/WM/0023

  • Date of REC Opinion

    21 Feb 2024

  • REC opinion

    Further Information Favourable Opinion