This was a single-center, retrospective cohort study of female patients diagnosed with OAB in a large Dutch non-academic teaching hospital. We enrolled patients referred to the outpatient urology clinic between January 1st, 2014, and September 30th, 2016. Electronic medical records (EMRs) were further checked for exclusion criteria, including age <18 years and other pathology that could explain the OAB symptoms (e.g., urinary tract infection, bladder tumor, bladder stones or anatomic abnormalities, and neurogenic OAB). Follow-up ended when a patient experienced satisfactory response and did not require further treatment, or on January 1st, 2020. The choice of treatment was made by the patient and the urologist from among PFMT, antimuscarinics, mirabegron, PTNS, BoNT-A, and since 2017, SNM. We defined successful treatment as the satisfactory reduction of symptoms with no need for further treatment, as evaluated in an outpatient visit or phone call by the treating urologist. Treatment combinations offered more than ten times are reported separately, but those offered less often are reported as “other combined therapy.”
The number, sequence, and duration of offered treatment steps were analyzed, and the effectiveness, reasons for discontinuation, and possible case-mix variables influencing OAB treatment were studied. We used Display R (www.displayr.com) to create This was created using data for all participants, including those with no follow-up data. Treatment duration was assessed using only patients with at least one follow-up contact recorded in the EMR after starting treatment. Statistical analysis was done with IBM SPSS version 24 (IBM Corp., Armonk, NY, USA). a Sankey’s plot to visualize the sequence of OAB treatments.