The management of overactive bladder refractory to medical therapy
Robinson D, Giarenis I, Cardozo L. Maturitas. 2013 Feb 14. pii: S0378-5122(13)00022-4. doi: 10.1016/j.maturitas.2013.01.013. [Epub ahead of print]


Department of Urogynaecology, Kings College Hospital, United Kingdom. Electronic address:


Overactive bladder (OAB) is a clinical syndrome describing the symptom complex of urgency, with or without urgency incontinence and is usually associated with frequency and nocturia. Whilst many women may be initially managed using a clinical diagnosis alone a number will fail primary therapy and will require further investigation. Those women with refractory symptoms following initial conservative and medical therapy may benefit from alternative treatment modalities including intravesical Botulinum toxin, neuromodulation or reconstructive surgery. This review, the second of two covering the treatment of intractable OAB symptoms in women, will focus on management following the failure of medical therapy. It will principally focus on the role of Botulinum toxin, neuromodulation and reconstructive surgery.