Raoul Concepcion, MD: OAB Patients Presenting in Primary Care

Raoul Concepcion, MD, director of the Comprehensive Prostate Center: I think overactive bladder, for the most part actually, [these patients] do see, many times, their primary care physicians, usually with a myriad of symptoms. It could be urinary frequency, it could be urinary urgency - the sort of the need to, "boy, when I go to go and I've got to urinate, I've got to go right then right now." The other way that they do show up to primary care is with some urinary symptoms, as well as with some element of incontinence, whether it be stress incontinence or urge incontinence.

I think a lot of primary care doctors, also dependent upon their penetration into managed care, oftentimes may start some of these patients on first- or second-line therapy, but then if those those particular first-line therapies don't work, then the next layer of therapy, second-line therapy, usually falls into some sort of oral medication.

Now recently, over the past few years, you have a new drug - a new family of drugs - that basically works on the beta receptor. It's got a little bit of a different mechanism, but again, it may have potentially a lower side-effect profile, specifically with the dry mouth and specifically with the lack of central nervous system side-effects. Now once a patient, however, fails to respond in an appropriate fashion or in a satisfactory fashion to those oral agents, at that point many of them will then get referred either to the urologist or the urogynecologist.