Combined Therapy Superior to Monotherapy in Overactive Bladder Patients with Pelvic Organ Prolapse: A Retrospective Comparative Study

Abstract

Objective: To compare short-term outcomes of behavioral, anticholinergic, and combined therapies in overactive bladder (OAB) patients with pelvic organ prolapse (POP). Methods: This single-center retrospective study included 90 women with OAB and POP (POP-Q stage ≤2) categorized as: Group 1 (behavioral therapy; n=30), Group 2 (anticholinergic therapy; n=30), and Group 3 (combined therapy; n=30). Validated questionnaires (IIQ-7, UDI-6, OAB-V8, ICIQ-SF) were used to assess symptom severity and quality of life (QoL) pre- and post-treatment. Statistical analyses employed ANOVA and paired t-tests, with p<0.05 considered significant. Results: All groups showed significant improvement in all questionnaires post-treatment (p<0.05), except UDI-6 in Groups 1 and 2. Combined therapy (Group 3) achieved the greatest reductions in scores: ICIQ-SF: (Δ10.74), IIQ-7: (Δ4.57), OAB-V8: (Δ4.31). Behavioral therapy (Group 1) outperformed anticholinergic therapy alone (Group 2) in symptom reduction (IIQ-7: Δ4.69 vs. Δ2.55; OAB-V8: Δ2.83 vs. Δ3.62; both p<0.05). Daily pad usage differed significantly among groups (Group 1: 2.2±1.4; Group 2: 3.1±0.8; Group 3: 4.3±1.3; p<0.001). Conclusion: While all therapies improved OAB symptoms, combined behavioral-pharmacological therapy demonstrated superior efficacy in reducing symptom severity and enhancing QoL in patients with concomitant POP. Behavioral monotherapy may be more effective than anticholinergic alone, supporting multimodal approaches as first-line management.

Keywords

• Anticholinergic
• Combined treatment
• Conservative treatment
• Overactive bladder
• Pelvic organ prolapse

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