Struggling with an overactive bladder? New tech and treatment options could help

Posted January 21, 2019 10:20 a.m. EST

New classes of overactive bladder drugs have different mechanisms of action that may prove to be more effective for some patients than other anticholinergic activity drugs. (Ocskay Mark/Big Stock Photo)

This article was written for our sponsor, Cape Fear Valley Health.

Overactive bladder affects 33 million Americans and is a condition that can interfere with daily life, from work and social activities to exercise and sleep.

Most people who have OAB experience a sudden urge to urinate that cannot be controlled. Other symptoms include incontinence, frequent urination and having to use the bathroom several times during the night. These issues can cause anxiety or depression and can even negatively impact relationships if left untreated.

According to Dr. Juan Lopez., a board-certified urologist at Cape Fear Valley Health, the most common treatment for the last 10 to 15 years for overactive bladder has included anticholinergic activity drugs. These drugs block the neurotransmitter acetylcholine and decrease the bladder's urine production.

Neurotransmitters are chemicals made by the nerves that travel to other nerves, muscles or glands where they attach to receptors and can either stimulate or inhibit the activity of those cells.

Unfortunately, not everyone responds favorably to these treatments, and some can experience dry eyes and mouth, or constipation during treatment and choose to discontinue use of the medication.

In addition to his clinical practice, Lopez also works with Carolina Institute of Clinical Research, a joint venture of Cape Fear Valley Health and Wake Research Associates. He has sat on institutional review boards and has been involved in clinical research programs for many years.

Prior to joining Cape Fear Valley, he helped run clinical research in his Florida practice where he worked for 25 years. When Cape Fear Valley recruited him to help with its new clinical research program, he welcomed the opportunity with open arms.

Now tasked with overseeing a new overactive bladder trial, Lopez is working with different pharmaceutical companies in Phase 2 or Phase 3 of FDA trials to determine if innovative drug therapies are good alternatives to the anticholinergic drugs.

"There are several different drug options for treating patients [with overactive bladder]," Lopez explained. "One just isn't always effective, so we always welcome new drugs that become available."

Trials like the upcoming overactive bladder studies at Cape Fear Valley are typically double-blind, placebo-controlled studies. In other words, both doctors and study participants don't know who is taking the new drug versus who is taking the placebo (sugar pill). This eliminates any inherent bias in the studies.

These new classes of OAB drugs that Lopez will be testing have different mechanisms of action that may prove to be more effective for certain patients.

One new drug targets beta receptors instead of cholinergic receptors.

Like the current anticholinergic drugs, this new beta receptor drug allows the bladder to relax, relieving that feeling of urgency and frequency. But since it works differently physiologically, those who do not experience positive results with the traditional anticholinergic medication may react more favorably to these.

Another study will test intravesical Botox.

While not a new treatment for overactive bladder, it currently requires sedation or anesthesia. The Cape Fear Valley study will test a new, less invasive procedure that involves filling the bladder with Botox via absorption into the bladder wall -- instead of injection with a needle -- to partially paralyze the bladder muscle.

Studies like these are a focus in today's medical world, and are helping to advance new technologies and treatment options for those who suffer from OAB.

"What excites me is a new approach to treat the disease with drug therapy," Lopez said. "Clinical research offers patients treatment options that would not otherwise be available. It affords them an early avenue into future treatments for these issues."

For Cape Fear Valley Health, these clinical research endeavors are fairly new.

The hospital has expanded significantly over recent years, and part of that effort has been in setting up an institute to help provide patients with clinical research options that are not yet available. This gives patients alternatives they wouldn't normally have with traditional healthcare.

This article was written for our sponsor, Cape Fear Valley Health.