Recent advances in managing overactive bladder

Araklitis, George; Baines, Georgina; Silva, Ana Sofia Da; Robinson, Dudley; Cardozo, Linda

doi:10.12688/f1000research.26607.1

Cited by 17 publications

(26 citation statements)

References 51 publications

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“…Patients with OAB cost the US healthcare system two and half times as much as equivalent patients without OAB [ 6 , 7 ]. Despite the detrimental effect on work, daily living, sexual function, and negative impact on the quality of life (QoL), OAB patients seeking treatment for their symptoms have been low in recent years because of its invasiveness such as surgery [ 8 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Posterior Tibial Nerve Stimulation for Overactive Bladder: Mechanism, Classification, and Management Outlines

Al-Danakh

Safi

Alradhi

et al. 2022

Parkinson's Disease

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Purpose of the Review. Posterior tibial nerve stimulation (PTNS) techniques have dramatically grown after approval to manage overactive bladder (OAB). The present review will focus on the most current data on PTNS types (percutaneous, transcutaneous, and implant) and their mechanism of action, safety, efficacy, advantages, drawbacks, limitation, and clinical applications. Recent Findings. The present review described the recent studies that addressed the tibial nerve stimulation role in OAB management. BlueWind RENOVA system, Bioness StimRouter, and eCoin are examples of emerging technologies that have evolved from interval sessions (percutaneous PTNS and transcutaneous PTNS) to continuous stimulation (implants). These can be efficiently managed at home by patients with minimum burden on the health system and fewer visits, especially in the COVID-19 pandemic. Summary. Our review shows that the tibial nerve stimulation advancements in OAB treatment have been rapidly increasing over the recent years. It is minimally invasive and effective, similar to sacral nerve stimulation (SNM), but less aggressive. Implantable PTNS has been promised in terms of efficacy, safety, and high acceptance rate. However, evidence is still limited to short-term trials, and tolerability, method, and drawbacks remain challenges.

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Section: Introductionmentioning

confidence: 99%

Posterior Tibial Nerve Stimulation for Overactive Bladder: Mechanism, Classification, and Management Outlines

Al-Danakh

Safi

Alradhi

et al. 2022

Parkinson's Disease

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“…The pharmacotherapy of OAB relies essentially on the use of two β 3 -adrenergic agonists: vibegron ( Gemtesa ® , FDA-approved in 2020) and mirabegron ( Myrbetriq ® , FDA-approved in 2012) with a comparable limited efficacy, even if vibegron, with less side effect on blood pressure, is often preferred to mirabegron [ 5 , 6 , 7 , 8 ]. A few other options are available, including the use of botulinum toxin A, neuromodulation with implantable devices, and laser treatment but their efficacy is limited [ 9 , 10 , 11 ]. The search for novel treatment modalities and drugs continues.…”

Section: Introductionmentioning

confidence: 99%

Rac1 as a Target to Treat Dysfunctions and Cancer of the Bladder

Sauzeau

Beignet²,

Bailly

2022

Biomedicines

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Bladder pathologies, very common in the aged population, have a considerable negative impact on quality of life. Novel targets are needed to design drugs and combinations to treat diseases such as overactive bladder and bladder cancers. A promising new target is the ubiquitous Rho GTPase Rac1, frequently dysregulated and overexpressed in bladder pathologies. We have analyzed the roles of Rac1 in different bladder pathologies, including bacterial infections, diabetes-induced bladder dysfunctions and bladder cancers. The contribution of the Rac1 protein to tumorigenesis, tumor progression, epithelial-mesenchymal transition of bladder cancer cells and their metastasis has been analyzed. Small molecules selectively targeting Rac1 have been discovered or designed, and two of them—NSC23766 and EHT 1864—have revealed activities against bladder cancer. Their mode of interaction with Rac1, at the GTP binding site or the guanine nucleotide exchange factors (GEF) interaction site, is discussed. Our analysis underlines the possibility of targeting Rac1 with small molecules with the objective to combat bladder dysfunctions and to reduce lower urinary tract symptoms. Finally, the interest of a Rac1 inhibitor to treat advanced chemoresistance prostate cancer, while reducing the risk of associated bladder dysfunction, is discussed. There is hope for a better management of bladder pathologies via Rac1-targeted approaches.

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“…Sacral neuromodulation requires invasive implantation by a skilled surgeon and may pose compatibility issues with MRI, involve staging, or necessitate recharging. Percutaneous tibial nerve stimulation either involves a surgical procedure or weekly visits during the treatment 11 . Therefore, there is a great need for a low‐cost, efficient, and minimally invasive OAB therapy.…”

Section: Introductionmentioning

confidence: 99%

Detrusor nerve radiofrequency ablation (DENERA): Experimental study of safety and efficacy in an ovine model

Ghoniem,

Mao,

Csuka

et al. 2023

Neurourology and Urodynamics

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PurposeThe subtrigonal perivesical nerve plexus contains a large proportion of the bladder's innervation. A transurethral radiofrequency ablation approach has successfully denervated this region to alleviate overactive bladder symptoms, with some urothelial heat injury. We report a novel transvaginal RFA device (DENERA) and assess its feasibility and efficacy in denervating the perivesical nerve plexus of in vivo sheep.MethodsIn 14 adult female in vivo sheep, pulsed radiofrequency energy was applied transvaginally for three cycles of 4 min, maintaining the tissue temperature at 45°C, with 30 s of rest between each cycle. The control group (n = 4) was sacrificed without ablation, and various groups were sacrificed 1 week (n = 3), 4 weeks (n = 4), and 12 weeks (n = 3) after ablation. The bladder subtrigones were harvested then analyzed with H&E, S100, and TH immunostaining to quantify their neural density and neural vacuolization.ResultsThe ablation procedure increased the neural vacuolization the most at 1 week and decreased the neural density the most at 4 weeks, with both variables displaying a significant change followed by a slight rebound towards baseline at 12 weeks. The H&E analysis showed that the needles penetrated deep into the subtrigonal detrusor muscle. The sheep recovered from the procedure with no complications or damage in the bladder wall or urothelium.ConclusionsThis study shows that one DENERA treatment can cause subtrigonal denervation with some rebound afterwards and no complications. DENERA may become a promising OAB treatment option that can ablate the perivesical plexus without harming the urothelium.

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Recent advances in managing overactive bladder

Cited by 17 publications

References 51 publications

Posterior Tibial Nerve Stimulation for Overactive Bladder: Mechanism, Classification, and Management Outlines

Posterior Tibial Nerve Stimulation for Overactive Bladder: Mechanism, Classification, and Management Outlines

Rac1 as a Target to Treat Dysfunctions and Cancer of the Bladder

Detrusor nerve radiofrequency ablation (DENERA): Experimental study of safety and efficacy in an ovine model

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