Study design, materials and methods
Google trends (GT) was used to analyse the level of patient online interest in various therapies to treat OAB. GT generates a relative search volume (RSV) index on a scale 0-100 between search terms which represents interest in a research topic on a scale 0-100. The RSV index does not represent absolute search volume. RSV operates as follows: an RSV score of 0 indicates that sufficient data were not found, while a score of 100 is assigned to the highest search frequency of a given term. The terms ‘Oxybutynin’, ‘Mirabegron’, ‘Solifenacin’, ‘sacral nerve stimulation’ and ‘bladder botox’ were entered into the GT search engine. Data from January 2005 to January 2025 were included. Geographical distribution tools were utilised to calculate the relative percentage of each search term for individual countries.
Results
The level of online interest worldwide was highest for Oxybutynin over the last 20 years. In 2005 Oxybutynin RSV was 25 which gradually increased to reach and remain between 80 to 100 since 2021. The countries most interested in Oxybutynin were South Africa (78% of searches), United States (76%), Kenya (62%), Sri Lanka (59%) and Nigeria (58%). Mirabegron gradually increased in search volume from 2011 to reach RSV 59 in 2025, the second most popular. Countries most interested in Mirabegron were Spain (87%), Italy (79%), Mexico (75%), Brazil (71%) and the Netherlands (65%). Solifenacin gradually increased in interest from 2006 to reach RSV 57 in 2025. Countries most interested in Solifenacin were Slovakia (80%), Czechia (75%), North Macedonia (69%), Croatia (63%) and Bulgaria (61%). Bladder botox injections appeared in GT in 2006 and reached RSV 9 in 2025. Countries most interested in bladder botox are Ireland (9%), South Africa (7%), United Kingdom (6%). Sacral nerve stimulation appeared in 2011 and currently has RSV 2. Countries most interested are Denmark (12%), Australia (3%) and Hungary (3%).
Interpretation of results
Oxybutynin is the oldest drug in the treatment of OAB and consequently remains the most popular despite the undesirable side effect profile and associated dementia risk. The popularity is likely driven by its low-cost and availability. Mirabegron has a substantial presence in Europe and South America especially compared to USA. In Spain it dominates 87% of searches compared to only 8% in USA likely reflecting a pharmaceutical and/or manufacturing influence. Solifenacin has a strong presence in some European and Middle-eastern countries. USA again demonstrated little interest in Solifenacin at only 8% of searches. Whilst bladder botox injections and sacral nerve stimulation show some isolated interest, the level of public interest remains comparatively low. These treatment modalities are more invasive and usually reserved as second or third line treatment options which may explain its relatively lower popularity.