Abstracts from the New England Section of the AUA 2021

NE-AUA 2021 Abstracts Scientific Session VII: Female/Neuro 35 Vibegron for the Treatment of Patients With Dry Overactive Bladder: A Subgroup Analysis From the EMPOWUR Trial Michael Kennelly, MD 1 , David Staskin, MD 2 , Jeffrey Frankel, MD 3 , Susann Varano, MD 4 , Diane K. Newman, DNP, ANP-BC 5 , Matt T. Rosenberg, MD 6 , Denise Shortino, MS 7 , Rachael A. Jankowich, RN, MSN 7 , Paul N. Mudd, Jr., PharmD, MBA 7 1 Carolinas Medical Center, Charlotte, NC, USA; 2 Tufts University School of Medicine, Boston, MA, USA; 3 Seattle Urology Research Center, Seattle, WA, USA; 4 Clinical Research Consulting, Milford, CT, USA; 5 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 6 Mid-Michigan Health Centers, Jackson, MI, USA; 7 Urovant Sciences, Irvine, CA, USA Introduction : Overactive bladder (OAB) is characterized by urinary urgency, often accompanied by frequency and nocturia, with or without urge urinary incontinence (UUI), referred to as OAB wet and dry, respectively. In the phase 3 EMPOWUR trial, vibegron—a β 3 -adrenergic agonist approved for the treatment of adult patients with OAB—was associated with significant improvements in daily number of urgency episodes (the need to urinate immediately) and micturitions vs placebo ( P <0.01). These post hoc analyses of EMPOWUR assessed efficacy outcomes in patients with OAB wet and OAB dry. Materials & Methods : In the EMPOWUR trial, patients were randomly assigned 5:5:4 to receive vibegron 75mg, placebo, or active control (tolterodine 4 mg extended release), respectively, for 12 weeks. OAB wet criteria included an average of ≥8 micturitions and ≥1 UUI episode per diary day. Up to 25% of patients could have OAB dry, defined as an average of ≥8 micturitions, ≥3 urgency episodes, and <1 UUI episode per diary day. Outcomes assessed included change from baseline (CFB) in average daily number of urgency episodes and micturitions. Results : Of the 1463 patients included in the full analysis set, 1127 (77%) had OAB wet (vibegron, N=403; placebo, N=405; active control, N=319), and 336 (23%) had OAB dry (vibegron, N=123; placebo, N=115; active control, N=98). Vibegronwas associatedwith significant reductions vs placebo in least squares (LS) mean (95%CI) CFB at week 12 in urgency episodes for the wet (-3.0 [-3.3, -2.6] vs. -2.4 [-2.7, -2.0], respectively; P <0.05) and dry (-2.6 [-3.2, -2.0] vs. -1.6 [-2.2, -0.9]; P <0.05) populations; significant reductions were also seen with vibegron vs placebo at weeks 2, 4, and 8 for both populations ( P <0.05, each). Vibegron was associated with significant reductions vs placebo in LS mean (95% CI) CFB at week 12 in number of micturitions for the wet (-2.1 [-2.4, -1.9] vs. -1.7 [-1.9, -1.5], respectively; P <0.01) and dry (-1.8 [-2.3, -1.3] vs. -1.0 [-1.5, -0.5]; P <0.05) populations; significant reductions were also seen with vibegron vs. placebo at weeks 2, 4, and 8 in the wet population and at weeks 4 and 8 in the dry population ( P <0.05, each). Conclusions : Once-daily vibegron 75 mg is associated with significant reductions vs placebo in daily urgency episodes and number of micturitions in patients with OAB wet and dry, suggesting that vibegron works similarly for these endpoints in OAB wet and in OAB dry. 70 Content and Readability of Robotic and Laparoscopic Sacrocolpopexy Information Online Remington Lim, BA 1 , Joanna Wang, MD 2 , Liz Wang, MD 2 , Linda Ng, MD 2 , Shaun Wason, MD 2 , David Wang, MD 2 1 Boston University School of Medicine, Boston, MA, USA; 2 BostonMedical Center, Boston, MA, USA Introduction: Apical pelvic organ prolapse (POP) is a common condition that impacts women, with up to 18% of affected women receiving surgical intervention. Currently, sacrocolpopexy is considered the gold standard surgical treatment. With recent advances in laparoscopic and robotic techniques, many institutions offer this minimally invasive approach as the preferred treatment modality. In today’s digital era with the emergence of telehealth amidst the Covid-19 pandemic, many look to the internet for medical information. In an unregulated webspace, people may experience difficulties searching for and understanding information online. In this study, the content and readability of select internet pages describing robotic and laparoscopic sacrocolpopexy were evaluated. Materials &Methods: Using an online keyword planner, the phrases “robotic sacrocolpopexy” and “laparoscopic sacrocolpopexy” were determined to be the most popular search terms. These terms were systematically browsed in Incognito mode in three of the most popular web search engines: Google, Yahoo, and Bing. Links that were non-text primary, duplicate, irrelevant, and non-English were excluded. Flesch-Kincaid Grade Level and Flesch-Kincaid Reading Ease indices were used to assess readability. These scores were analyzed using a one-way ANOVA on ranks. Results: Of 300 total results, 54 unique sites were analyzed. 18 (33.3%) of these sources were private practice, 16 (29.6%) academic, and 7 (13.0%) non-academic. There were 26 (48.1%) obstetric/gynecologic-specific sites, 6 (14.8%) urology-specific sites, and 19 (35.2%) specialty-unspecified sites. The average readability of all sites was 12.9, requiring at least a 12th grade reading level, which is significantly higher than the recommendedAMA/NIH level of 7th grade or below. 53 (98.1%) sites were above the recommended 7th grade reading level. 36 (66.7%) sites were written at the 12th grade level or higher. Only 8 (14.8%) were written below a high school reading level of 9.0. There was no significant difference betweenmean grade level or reading ease score from the type of web source (p=0.32 and 0.34, respectively), approach of surgery (p=0.91, 0.70), or specialty (p=0.48, 0.36). Conclusions: Despite the internet’s accessibility and breadth of information, navigating online resources may be challenging for a patient considering surgical management of apical POP with sacrocolpopexy. Our study shows almost all websites require at least a high school education to properly comprehend, regardless of source or specialty. Additionally, gynecologic sources outnumber those of urology, which aligns with previous studies demonstrating gynecologists perform a greater proportion of sacrocolpopexies. It is important that providers be aware of available resources, so they may direct patients to specific sites that are personally validated or provide in-office materials at an appropriate reading level. 69