Dr. Jason Kim

And oftentimes they're told by physicians there's nothing else that can be done after they fail medications.

I can't tell you how many times I've had a patient come in who's had overactive bladder for many years and maybe they tried some of these interventions.

When I even start to talk about some of the procedural interventions, they leave my office crying even before we've done anything.

For the first time, someone's given them some hope.

They thought it was hopeless.

A lot of times they come in thinking nothing can be done.

And I think that's one of the most amazing things to see the patient, to give them that hope.

Well, overactive bladder is a clinical diagnosis.

So basically, we take a good history and physical.

And the kind of questions I ask are, how often do you go to the bathroom?

Do you have urinary urgency?

Do you have urgency incontinence?

Do you wake up at night to urinate?

These are the kind of questions that I would ask that I think would indicate overactive bladder.

I think there were a few things that caught my eye about the new guidelines.

I think the biggest one is they removed the stepwise fashion.

As you know, we always used to talk about first line therapy, second line therapy, and third line therapy used to refer to the procedural interventions.

They've removed it now.

And for example, third line therapy is now called minimally invasive therapy.

And now the guidelines don't advocate a stepwise fashion.