Overactive bladder (OAB) is a clinical syndrome encompassing bothersome urinary urgency, frequency, nocturia, and urgency incontinence that is commonly encountered by urologists in clinical practice. While OAB is estimated to affect at least 15% of the population (ranges 7%-27% in men and 9%-43% in women),^1,2 overall treatment rates remain low for both second-line (medications) and third-line (advanced) therapies.

In 2022, I was fortunate to be part of a group who worked with the AUA data team to build the AQUA OAB data dictionary. We used this data cohort to publish 2 initial manuscripts examining trends in OAB management amongst urologists. The first examined how insurance and demographic factors impact medication selection for patients with OAB;³ the second examined trends in third-line therapy, looking at who receives third-line therapy along with how long it takes to progress to these therapies.⁴ However, like any good research project, our findings from these initial manuscripts led to more unanswered questions that will be explored in this next project.

For example, a question that stood out is why are OAB therapy rates in men so low? In the study by Jericevic et el.,⁴ while twice as many men were diagnosed with OAB and storage LUTS during the study period, men were less likely to receive third-line therapy (OR 0.39, CI 0.37-0.41). Additionally, for men who did receive third-line therapy, there was a longer lag time from diagnosis to treatment compared to women (19.1 months [IQR 8.1-36.7] vs 13.9 [IQR 8.1-36.7], P < 0.01) after receiving second-line therapy. This finding has been demonstrated both in our own studies mentioned above along with other published data.^5,6 One assumption is that men are preferentially receiving BPH-related therapies to address BPH diagnoses in lieu of OAB therapies, but there are little published data that take into account both diagnoses. One of the aims of the 2024 data award is to examine how the presence or absence of a BPH diagnosis may impact treatment decisions in men with OAB while considering other factors such as age, race, geographic location, and insurance type.

Aside from getting to delve deeper into these questions that impact patient care, I am delighted to be able to work with the AUA data team to further utilize and promote the AQUA Registry as a valuable research tool. I appreciate this opportunity to collaborate with the AUA to better understand how patients with OAB are being managed by urologists in the US.