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BackTable Urology

Ep. 296 Overactive Bladder Management: Updates and Guidelines with Dr. Jason Kim

31 Mar 2026

Transcription

Chapter 1: What is the main topic discussed in this episode?

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Chapter 2: What are the latest updates in overactive bladder management?

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You'll get early access to episodes, case discussions, and courses in one place. Just search Backtable in the App Store or Google Play on your phone. The urgency is real and we feel it. The time is now for bladder control. You're here for the hard calls, the quiet progress, and the breakthrough moments.

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Chapter 3: How does the patient experience shape OAB treatment?

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Chapter 4: What are the differences between beta-3 agonists and anticholinergics?

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This week on the Backtable podcast.

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53.472 - 71.787 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.

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Chapter 5: How is Botox used in the management of overactive bladder?

71.767 - 77.521 Dr. Jason Kim

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.

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Chapter 6: What role does tibial nerve stimulation play in OAB treatment?

78.142 - 82.553 Dr. Jason Kim

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

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89.755 - 105.568 Dr. Anjali Kapoor

Hi, everyone. Welcome to Backstable Urology. I'm your host today, Dr. Anjali Kapoor. I'm a urogynecologist and reconstructive pelvic surgeon in central New Jersey with Hackensack Meridian Health. And today I'm joined by a mentor, a colleague, and a friend, Dr. Jason Kim.

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105.628 - 113.635 Dr. Anjali Kapoor

He is a professor of urology at the Renaissance School of Medicine at Stony Brook University, where he specializes in urogynecology and reconstructive pelvic surgery.

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Chapter 7: How does sacral neuromodulation impact OAB management?

113.755 - 127.687 Dr. Anjali Kapoor

He completed his residency training at Stony Brook University and fellowship training at Virginia Mason Medical Center. Dr. Kim serves as Director of the Women's Pelvic Health and Continence Center at Stony Brook and as the Fellowship Program Director of the Earps Fellowship at Stony Brook.

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127.807 - 143.02 Dr. Anjali Kapoor

He's actively involved in national education efforts and he serves on the Executive Board of SUFU and as Chair of the Resident Education Committee. His clinical and research interests include overactive bladder, neuromodulation, pelvic organ prolapse, stress incontinence, and innovations in urodynamics.

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143.04 - 163.104 Dr. Anjali Kapoor

He is passionate about advancing evidence-based care while improving the patient experience in functional urology. And so today we're diving deep into the topic of overactive bladder in women. This is an important topic within both general urology and urogynecology, and the guidelines and options for management have evolved significantly in the past few years.

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Chapter 8: What is the cost burden associated with overactive bladder treatments?

163.745 - 169.172 Dr. Anjali Kapoor

So Jason, if you could start us off, how do you define overactive bladder in your practice?

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169.574 - 188.359 Dr. Jason Kim

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.

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188.761 - 212.072 Dr. Anjali Kapoor

And so with that, I just want to say today we're mainly talking about overactive bladder in women, not necessarily overactive bladder related to BPH in men and not neurogenic lower urinary tract dysfunction. I want to kind of segue into creating the foundation with the newer guidelines that were released in 2024 on the diagnosis and management of idiopathic overactive bladder in women.

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212.272 - 218.16 Dr. Anjali Kapoor

Maybe you could start us off with just some of the major differences in the guidelines with the update that we now follow.

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218.528 - 236.956 Dr. Jason Kim

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.

237.136 - 257.405 Dr. Jason Kim

And now the guidelines don't advocate a stepwise fashion. You can start with procedural intervention if you'd like after discussion with a patient. Although the guidelines remove the need for stepwise therapy, unfortunately, a lot of insurance companies still require it. So we still kind of practice in that way for the most part. I think the other thing is the emphasis on shared decision making.

257.425 - 277.707 Dr. Jason Kim

I know I do a lot of shared decision making with my patients, especially when it comes to procedural intervention. There are multiple different types of procedures and I discuss them all and have a discussion about pros and cons and figure out what is best for each patient. I don't think any therapy is best for every patient. I think there was also some things about telemedicine in there.

277.727 - 292.663 Dr. Jason Kim

I've utilized that very well in my practice. Typically, for example, if we start pharmacotherapy, instead of having the patient come in, I'll often do a telemedicine, which I think is more efficient for the patient, for our practice, and allows us to see more patients and get them in quicker.

292.897 - 309.69 Dr. Anjali Kapoor

Do you feel like patients would go for minimally invasive therapies off of a telemedicine visit when they're first just being diagnosed with overactive bladder? Or are those the patients that kind of start with medications and also need more of a workup in the clinic with an exam before you offer that?

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