Alternative Treatment Methods for Refractory Overactive Bladder

Overactive bladder is a serious condition that can significantly impair quality of life. Antimuscarinic agents are recommended as second-line therapy in patients who do not benefit from behavioral therapy. However, the therapeutic efficacy of antimuscarinic agents is limited. Alternative treatment methods to medical treatment have been developed due to its limited effectiveness and frequent side effects. Posterior tibial nerve stimulation (PTNS), transcutaneous tibial nerve stimulation (TTNS), sacral neuromodulation (SNM), intravesical Botulinum toxin-A (BoNT/A) are prominent among these minimally invasive treatment methods in refractory OAB. All these methods have been demonstrated to be effective in the literature. BoNT/A and SNM are more effective, but have been reported to cause more side effects. In refractory OAB, any of these methods can be applied by considering the medical condition and request of the patient.