Managing and Evaluating Success Rates for OAB Patients
We all know that patients refractory to OAB first and second line treatments are those most difficult to “cure,” even with ongoing treatment. There will be at least 20% of those that will not reach their goals. When you look at the data for long-term third line therapy, there will never be 100% cure rates or even 100% improvement rates.
Percutaneous tibial nerve stimulation (Urgent® PC) notes success of 77% improvement (Peters, K 2013) at 3 years for patients who continued with ongoing treatment. Interstim®, or sacral neuromodulation, demonstrates a 62% rate of improvement after 5 years (Groen, 2011) while Botox® provides 55-50% continence after month 3 with repeat injections about every 9 months (Denys, P, 2012).
Overall that leaves us with 20-50% of refractory OAB patients that do not reach their treatment goals. These numbers do not include those who get dual therapy with medications, pelvic floor therapy and/or neuromodulation or Botox.
So what is our responsibility as providers of care for OAB patients?
Never promise your patients a cure.
Explain all the possibilities with pros and cons.
Offer your patients all options of available treatments.
Help your patients develop realistic and manageable goals.
Use bladder diaries and/or quality of life surveys to determine objective responses.
Finally, be a great provider. Talk to your patients and be their advocate. You are the expert. Teach them, guide them and be available when they are not feeling great about their responses. Give them options!
This blog post reflects the opinions and experience of Leslie Wooldridge, a long-standing user of the Urgent PC Neuromodulation System, and was produced under a paid consulting agreement with Cogentix Medical.
Urgent PC is indicated for the treatment of Overactive Bladder and associated symptoms of urinary urgency, urinary frequency and urge incontinence. Treatment with Urgent PC is contraindicated for patients with pacemakers or implantable defibrillators, patients prone to excessive bleeding, patients with nerve damage that could impact either percutaneous tibial nerve or pelvic floor function or patients who are pregnant or planning to become pregnant during the duration of the treatment. Most patients don't experience side-effects. If side-effects occur, they are typically temporary and include mild pain and skin inflammation at or near the stimulation site. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician. For complete instructions for use, storage, warnings, indications, contraindications, precautions, adverse reactions and disclaimer of warranties, please refer to the insert accompanying each product or online at www.cogentixmedical.com. Models are for illustrative purposes only. Urgent is a registered trademark of Cogentix Medical © 2016 Cogentix Medical. All rights reserved.