When a patient presents with symptoms of Overactive Bladder, there are a lot of factors to consider as you build a treatment plan. The treatment pathway defined in the AUA/SUFU Guideline for OAB is a great place to start, but as you already know, each patient’s history and their symptoms will play a role in determining the treatments that might be successful and which therapies you might want to avoid.
In this seven part blog series, women’s health advocate Leslie Wooldridge, GNP-BC, CUNP, BCIA-PMD, shares knowledge she’s gained during nearly 30 years of caring for patients, particularly those suffering from incontinence and overactive bladder (OAB). Drawing on her significant experience with a wide range of therapies, including PTNS, Leslie discusses individualizing OAB treatment plans starting with the patient’s history and ending with how to define success for you and your patients.
Part 1: Patient History in Overactive Bladder Treatment
First and foremost, an accurate history is essential. … This is not by any means an exhaustive list of OAB etiology, but it's a start, especially for those of you just getting into treating these patients. … read more
Part 2: Physical Exam in Overactive Bladder Treatment
Many primary care providers do not do pelvic exams any more. If the patient complains of a problem, they prudently refer them. Keeping this in mind, it is important to be thorough in what we do in order to treat our patients properly and give them the best chance for successful outcomes. … read more
Part 3: Behavioral Management in Overactive Bladder Treatment
Behavioral management encompasses many aspects of treatment for OAB as well as other types of bladder issues including incontinence. … Individualizing plans for your patients becomes paramount in planning success. … read more
Part 4: Medications in Overactive Bladder Treatment
There are many medications on the market for OAB. Some have more side effects than others and some are dosed differently. The route of administration runs the gamut of pill, capsule, patch or gel. Most of them have issues especially their use in the elderly. Some cause very high percentages of constipation and dry mouth and yet others carry a blurred vision and CNS side effect that can be devastating for these same elderly, resulting in catastrophic co-morbidities. Are we making sure we know the make-up of all these drugs and which patients would benefit most by each one? … read more
Part 5: Choosing 3rd Line Therapy in Overactive Bladder Treatment
When behavioral management and medications aren’t enough to meet the goals of patients with OAB, it’s time to move on. There are three major 3rd line therapies approved for use in patients with OAB. … Let’s look at some of those co-morbidities as well as other issues to take into consideration and the problems they may present. … read more
Part 6: Using PTNS in Overactive Bladder Treatment
Refractory overactive bladder can be a challenging syndrome to treat. Successful treatment seems to take a long time to achieve as there a multiple things to rule out, to manage and to try. In this example, the patient has decided to try PTNS with Urgent PC as a 3rd line therapy. Here are some ways I set patients up for success: … read more
Part 7: Defining Treatment Success in Overactive Bladder Treatment
When patients with OAB are treated successfully, they feel as though you have given them their life back. How success is defined is very different for so many people. … read more
Leslie has also written posts on topics such as the future role of Nurse Practitioners in urology, how to deal with difficult ankles when treating OAB patients with PTNS, and more.
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. Urgent PC is a registered trademark of Cogentix Medical © 2016 Cogentix Medical. All rights reserved.