The AUA/SUFU Guideline on the Diagnosis and Treatment of Idiopathic Overactive Bladder

Abstract

Purpose: The purpose of this guideline is to provide evidence-based guidance to clinicians of all specialties on the evaluation, management, and treatment of idiopathic overactive bladder (OAB). The guideline informs the reader on valid diagnostic processes and provides an approach to selecting treatment options for patients with OAB through the shared decision-making process, which will maximize symptom control and quality of life, while minimizing adverse events and burden of disease. Methods: An electronic search employing OVID was used to systematically search the MEDLINE and EMBASE databases, as well as the Cochrane Library, for systematic reviews and primary studies evaluating diagnosis and treatment of OAB from January 2013 to November 2023. Criteria for inclusion and exclusion of studies were based on the Key Questions and the populations, interventions, comparators, outcomes, timing, types of studies and settings (PICOTS) of interest. Following the study selection process, 159 studies were included and were used to inform evidence-based recommendation statements. Results: This guideline produced 33 statements that cover the evaluation and diagnosis of the patient with symptoms suggestive of OAB; the treatment options for patients with OAB, including non-invasive therapies, pharmacotherapy, minimally invasive therapies, invasive therapies, and indwelling catheters; and the management of patients with BPH and OAB. Conclusion: Once the diagnosis of OAB is made, the clinician and the patient with OAB have a variety of treatment options to choose from and should, through shared decision-making, formulate a personalized treatment approach taking into account evidence-based recommendations as well as patient values and preferences.

Efficacy and Safety of Vibegron for Persistent Symptoms of Overactive Bladder in Men Being Pharmacologically Treated for Benign Prostatic Hyperplasia: Results From the Phase 3 Randomized Controlled COURAGE Trial

“…3 Men with BPH may develop bladder outlet obstruction (BOO), 3 which may contribute to the development of lower urinary tract symptoms (LUTS), including storage symptoms such as urinary frequency, urgency, nocturia, and urge urinary incontinence (UUI). 3,4 Notably the presence of storage symptoms is consistent with the diagnosis of overactive bladder (OAB), 3,5 and OAB symptoms have been associated with a substantial negative impact on health-related quality of life, as well as increased incidence of anxiety and depression. 6,7 A recent claims analysis estimated that LUTS affects 12.2% of commercially insured men > 40 years of age, with w19% of the study cohort having diagnoses for both BPH and OAB.…”