Ep. 296 Overactive Bladder Management: Updates and Guidelines with Dr. Jason Kim

What if we’re waiting too long to offer our OAB patients the treatments that actually work? In this episode of BackTable Urology, Dr. Jason Kim joins host Dr. Anjali Kapur to discuss updates in overactive bladder management and evolving guidelines, including a shift away from rigid stepwise care toward shared decision-making. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:06 - 2024 AUA/SUFU Idiopathic OAB Guideline07:32 - Patient Experience with OAB11:59 - Beta-3 Agonists vs Anticholinergics15:15 - Botox Counseling and Dosing18:11 - Tibial Nerve Stimulation25:47 - Sacral Neuromodulation32:09 - Cost Burden of OAB39:38 - Evolution of OAB Care41:39 - Future Research Directions --- More about this episode The conversation positions OAB as a clinical diagnosis, supported by focused initial evaluation and selective use of advanced testing, with attention to the emerging role of ambulatory urodynamics. Dr. Kim and Dr. Kapur review management across the care continuum, including behavioral strategies, pelvic floor physical therapy, and pharmacologic options, with consideration of beta-3 agonists in older patients. The discussion also focuses on earlier use of minimally invasive therapies such as intradetrusor Botox and neuromodulation, and how introducing these options sooner may improve follow-up, reduce delays, and help patients achieve symptom control more efficiently. --- Resources The AUA/SUFU Guideline on the Diagnosis and Treatment of Idiopathic Overactive Bladder (2024)https://www.auanet.org/guidelines-and-quality/guidelines/idiopathic-overactive-bladder Anticholinergic Drug Exposure and the Risk of Dementiahttps://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2736353 Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial https://pubmed.ncbi.nlm.nih.gov/20171677/ Trends in Utilization of Sacral Neuromodulation for Overactive Bladder: Insight From the AUA AQUA Registryhttps://www.auajournals.org/doi/10.1097/UPJ.0000000000000916 A retrospective longitudinal evaluation of new overactive bladder patients in an FPMRS urologist practice: Are patients following up and utilizing third-line therapies?https://pubmed.ncbi.nlm.nih.gov/33197059/