Economics of Overactive Bladder

OAB is a prevalent, costly disease that has significant personal and societal burdens. Therapy should graduate in invasiveness as necessary. Behavioral modification techniques are the ideal starting point. Anticholinergic medications should be used as the initial medical management. Drug selection should take into consideration individual patient needs regarding side-effect profile. Patients who fail to improve on medication alone should be offered 2nd line therapies including neuromodulation (SNS or PTNS) or intravesical injection of botulinum toxin A. Surgical options such as augmentation cystoplasty and diversion should be reserved for patients with neurogenic OAB who have failed other more conservative measures.