Optimizing Overactive Bladder Treatment

Overactive bladder (OAB) is a highly prevalent condition that negatively impacts the lives of millions of adults in the United States. Anticholinergic and beta‐3 agonist medications are commonly used to treat OAB but compliance is low due to variable efficacy and bothersome side effects. The existence of a urinary microbiome was recently discovered and early investigations have revealed that lower Lactobacillus load is correlated with the presence of OAB symptoms and a poorer response to anticholinergic therapy. This proposed pilot study is a randomized double‐blind placebo‐controlled trial (RCT) of concomitant probiotic therapy in women initiating medication therapy for OAB to explore how probiotics influence response to anticholinergic and beta‐3 agonist medications, investigate whether probiotic therapy alters the urinary microbiome, and assess for predictors of response to therapy. Primary Aim: To explore how concomitant probiotic therapy influences response to medication for OAB in a RCT Secondary Aims: 1. To investigate whether 4 weeks of probiotic therapy alters the urinary microbiome. 2. To assess for predictors of response to therapy