Editing CUA: Overactive Bladder (2017) (section)

== Answers ==

# What is the ICS definition of OAB?
#* Urinary urgency, with or without incontinence, often associated with frequency and nocturia, in the absence of infection or other pathology
# How does the prevalence of OAB differ between men and women?
#* Similar prevalence, women more likely to have OAB-wet
# What are the quality of life domains affected by OAB?
## Daily life
## Recreational life
## Psychological concerns
## Isolation
## Sexuality
## Work productivity
# As per the 2017 CUA Guidelines on OAB, what is the recommended work-up of a patient with OAB? Not recommended?
#* Recommended: History + physical, U/A, questionnaire, voiding diary
#* Not recommended: PVR, cystoscopy, imaging, urodynamics
# What are the indications to treat asymptomatic bacteruria? Should a low bacterial count (103–105 CFU/ml) in a patient with OAB be treated?
#* Pregnancy and patients undergoing urologic procedures involving breach of mucosa
#* Yes since symptomatic
# When should PVR be evaluated in a patient with suspected OAB?
## Obstructive symptoms
## Neurological diagnoses
## History of either prostatic or incontinence surgery
# When is UDS indicated in a patient with suspected OAB?
## Diagnosis uncertain
## Symptoms to not correlate with physical exam
## Failure of treatment
## Neurogenic voiding dysfunction
## Prior pelvic surgery or radiation
## High risk bladder storage features
# What are the first-line treatment options for OAB?
## Bladder training
## Pelvic floor physiotherapy
## Lifestyle changes
## Patient education
# What are the second-line treatment options for OAB?
## Oral anti-cholinergics
## Beta-3 agonists
# Which receptors do anti-cholinergics act on in the bladder?
#* M2 and M3 muscarinic receptors; M2 receptors predominate but M3 receptors mediate cholinergic contractions
# Which anti-cholinergic agents are available for treatment of OAB in Canada?
## Oxybutynin
## Fesoterodine
## Tolterodine
## Solifenacin
## Darifenacin
## Tropsium
## Propiverine
# Which anti-cholinergic agents are associated with cognitive impairment?
#* Oxybutynin
#* Solifenacin
# Which anti-cholinergic agents should be avoided/require dose adjustment with renal dysfunction? Hepatic dysfunction?
#* Renal: tolterodine, fesoterodine
#* Hepatic: oxybutynin, tolterodine, solifenacin, darifenacin
# What are potential adverse events related to the use of anti-cholinergic drugs to treat OAB?
#* Dry mouth
#* Pruritis
#* Constipation
#* CNS effects
# What are the contraindications to use of anti-cholinergic drugs?
#* Uncontrolled narrow-angle glaucoma
#* Functional GI obstruction
#* Myasthenia gravis
# When should a patient expect symptom improvement after initiating an anti-cholinergic for OAB?
#* 12 weeks
# What are potential adverse events related to the use of beta-3-agonist drugs to treat OAB?
## UTI
## Nasopharyngitis
## HTN
## Back pain
## Headache
# What are the contraindications to use of beta-3-agonist drugs?
## Pregnancy
## Uncontrolled HTN
# What is the starting dose for the different drugs used in OAB?
#* Oxybutynin 5mg
#* Fesoterodine 4mg
#* Tolterodine 4mg
#* Solifenacin 5mg
#* Darifenacin 7.5mg
#* Tropsium
#* Propiverine 30mg
# What are the third-line treatment options for OAB?
## Botox
## PTNS
## SNM
# What is the median duration of effect of intradetrusor botox?
#* 8 months
# What are potential adverse events related to the use of intradetrusor botox to treat OAB?
## UTI
## Dysuria
## Bacteruria
## Retention
# What are the fourth-line treatment options for OAB?
## Indwelling cathter
## Augmentation
## Diversion