Management of Overactive Bladder Refractory to Medical Therapy

Overactive bladder (OAB) is a clinical diagnosis given to patients presenting with urgency, with or without urgency incontinence usually accompanied by frequency and nocturia. OAB is prevalent and can significantly impair quality of life. Most patients with OAB will improve with conservative measures or pharmacologic management. However, there are currently multiple minimally invasive options for refractory patients. These include intradetrusor injections of botulinum toxin and two forms of neuromodulation: posterior tibial nerve stimulation and sacral neuromodulation.