Presentation Authors: Raphaëlle Brière*, Quebec, Canada, Patrick O. Richard, Sherbrooke, Canada, Matthieu Gratton, Quebec, Canada, Le Mai Tu, Sherbrooke, Canada
Introduction: Selective bladder denervation (SBD) fulgurates, using radiofrequency (RF) energy, sub-trigonal tissue containing afferent nerves to interrupt afferent signaling thought to cause overactivity bladder (OAB) symptoms. We studied the efficacy of SBD in female patients with refractory OAB and compared clinical outcomes between those with and without detrusor overactivity (DO) as established on baseline urodynamic study (UDS).
Methods: This was a prospective observational study of 23 refractory OAB female patients who underwent SBD, using a 60-second temperature-controlled RF protocol, between May 2016 to April 2017. Patients were categorized according to DO status (DO- vs. DO+) on baseline UDS. Clinical outcomes were assessed at 12 weeks and 12 months for: 24h pad weight test (PWT), 3-day voiding diary parameters and subjective improvement assessed via OAB-q short form, Treatment Benefit Scale and subjective improvement rate.
Results: Both DO- and DO+ groups reported significant improvement from baseline at 12 weeks in the 24h PWT, urgency urinary incontinence (UUI)/3 days and urgency/3 days, and at 12 months in urgency/3 days. Individually, at 12 months, the 24h PWT decreased in the DO- group whereas UUI/3 days decreased in the DO+ group. When separating voids according to Patient Perception of Intensity of Urgency Scale (PPIUS), urgency-related voids/24h (grades 3 and 4) significantly decreased and non-urgency-related voids/24h (grades 0 to 2) increased in both groups at 12 weeks and in DO+ group at 12 months, which may suggest that overall voiding frequency is more driven by habit than urgency. Only PPIUS grade 3/24h decreased in the DO- group at 12 months. When directly comparing both group outcomes, the only significant difference was the greater reduction in UUI/3 days in the DO- group at 12 weeks (-9.0 vs. -6.5; p=0.045). DO- and DO+ groups were all subjectively improved at each follow-up (table 1).
Conclusions: SBD appears to be an effective treatment, both objectively and subjectively, for refractory OAB female patients regardless of baseline DO status. These results need to be validated in a larger prospective randomized control trial.
Source of Funding: Partial funding from Amphora Medical Inc.