Refractory Overactive Bladder, now what?

Abstract

Overactive bladder is a highly prevalent condition. Consequences of this condition has a detrimental impact on quality of life, productivity, social relationships, physical activity, and mental health. The initial treatment of overactive bladder includes behavioural modification and pharmacotherapy. A significant proportion of patients will experience intolerable side-effects or inadequate relief with these measures. An understanding of the modern perspectives pertaining to the pathophysiology of the condition may prove helpful in these cases. However, in patient’s refractory to these treatment measures more advanced therapies should be offered. These include intravesical botulinum toxin injection, percutaneous nerve stimulation, and sacral nerve modulation. Each of these techniques have shown favourable efficacy; however, each with its own unique risk-benefit profile. This article will provide an overview of the advantages and disadvantages of the advanced third-line therapies available to patients with overactive bladder syndrome.