CME Newsletter #2

Progress in Practice: Special Considerations in the Management of Overactive Bladder
While much of the literature on overactive bladder (OAB) addresses the needs of women, the condition occurs equally in both sexes, and its prevalence increases with age. Although many OAB treatment strategies are available, some patients do not respond adequately to initial therapy, treatment selection for elderly patients can be challenging, and for all patients, the potential for adverse effects and drug-drug interactions must be minimized. This issue of The Urology University CME Newsletter presents an expert overview of these special considerations in OAB management. The authors review the workup of men with OAB symptoms, discuss the use of antimuscarinic agents in older adults, examine potential safety and tolerability issues associated with antimuscarinic agents, and offer management strategies for patients with refractory OAB. With an eye to the future, they also discuss investigational therapies that may have a role in the management of OAB.

Learning Objectives and Faculty

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Educational Objectives
At the conclusion of this activity, participants should be able to:
  • Discuss the role of overactive bladder (OAB) in male lower urinary tract symptoms (LUTS) and how to evaluate for OAB in men with LUTS
  • Recognize the potential for cognitive adverse effects with administration of antimuscarinic agents in the elderly and factors that may increase or decrease the likelihood of risk
  • Recommend second-line therapies for the management of refractory OAB
  • Minimize the risk for drug-drug interactions and adverse effects through an understanding of the metabolism of the various OAB agents and dosing recommendations

Faculty
Pamela I. Ellsworth, MD, Program Chair
Associate Professor of Surgery
Division of Urology
The Warren Alpert Medical School of Brown University
Providence, RI

Stephen A. Brunton, MD, Program Co-Chair
Adjunct Clinical Professor
Department of Family Medicine
University of North Carolina at Chapel Hill
Chapel Hill, NC
Director of Faculty Development
Cabarrus Family Residency Program
Concord, NC

Alan J. Wein, MD, PhD (Hon), Program Co-Chair
Professor and Chair
Department of Surgery
Division of Urology
University of Pennsylvania School of Medicine
Chief, Division of Urology
University of Pennsylvania Health System
Philadelphia, PA

Eric S. Rovner, MD
 Professor of Urology
Director, Section of Female Urology, Neurourology and Urodynamics
Department of Urology
Medical University of South Carolina
Charleston, SC


Faculty Disclosures
In accordance with the disclosure policy of the Warren Alpert Medical School of Brown University as well as standards set forth by the Accreditation Council for Continuing Medical Education, all speakers and individuals in a position to control the content of a CME activity are required to disclose relevant financial relationships with commercial interests (within the past 12 months). Disclosures of this activity’s speakers and planning committee have been reviewed and all identified conflicts of interest, if applicable, have been resolved.

Pamela Ellsworth, MD, is a consultant for Pfizer Inc and Allergan, Inc.; she is a speaker for Pfizer Inc; she has participated in speaker training for Novartis Pharmaceuticals Corporation; and she has participated in clinical research studies sponsored by Novartis Pharmaceuticals Corporation and Pfizer Inc. Stephen A. Brunton, MD, has no financial interests to disclose. Alan J. Wein, MD, PhD (Hon), is a consultant for Pfizer Inc, Astellas Pharma US, Inc., and Novartis Pharmaceuticals Corporation. Eric Rovner, MD, is a consultant for Allergan, Inc., Pfizer Inc, Astellas Pharma US, Inc., Solace Therapeutics, and Tengion; he is a speaker for Allergan, Inc., Pfizer Inc, and Astellas Pharma US, Inc.; and he has received grant or research support from Allergan, Inc., Pfizer Inc, Contura International A/S, and Solace Therapeutics.
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