Overactive bladder (OAB) affects 12-14% of the adult female population in the UK. Although rarely life-threatening, OAB can have a considerable negative impact on patients’ quality of life, restricting their social life and ability to work, and up-to social isolation in severe cases. OAB is first treated with lifestyle changes (such as reducing caffeine intake); pelvic floor exercises; bladder training and certain medications. Unfortunately these treatments do not work in 25-40% of patients (i.e. refractory OAB). These patients may be offered second line treatments such as injections of BOTOX into the bladder wall or SNM (an implant in the buttock which aim to regulate the bladder nerves in the lower spine).

Before recommending second line treatments, doctors are advised to perform a diagnostic invasive test called “Urodynamics” to confirm the diagnosis. Patients often find Urodynamics embarrassing and uncomfortable and in almost 40% of patients, Urodynamics does not show the underlying cause of the bladder problem and therefore it is unable to guide doctors and patients in their decision making.

The FUTURE study, funded by NIHR HTA Programme, is a randomised controlled trial that aims to recruit 1096 women to assess whether routinely performing Urodynamics, in addition to the standard comprehensive clinical assessment, improves the outcome of treatments in women with refractory OAB compared to comprehensive clinical assessment only. We also want to assess whether doing the test on everybody makes the best use of NHS resources.

The primary outcome measure is participant reported success at 15 months post randomisation (approximately 12 months post treatment) as measured by the Patient Global Impression of Improvement – Index.

The FUTURE study is led by Prof Mohamed Abdel-fattah based at the University of Aberdeen.

For more information please see the FUTURE Study Website



Ongoing - Data collection/follow up


Abdel-fattah M, Chapple C, Guerrero K, Dixon S, Cotterill N, Ward K, Hashim H, Monga A, Brown K, Drake MJ, Gammie A, Mostafa A, Bladder Health UK, Breeman S, Cooper D, MacLennan G, Norrie J. Female Urgency, Trial of Urodynamics as Routine Evaluation (FUTURE study): a superiority randomised clinical trial to evaluate the effectiveness and cost-effectiveness of invasive urodynamic investigations in management of women with refractory overactive bladder symptoms. Trials. 2021;22:745