Management of refractory overactive bladder

Maude E. Carmel, Howard B. Goldman

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


Overactive bladder has significant impact on a patient's quality of life. Conservative and pharmacologic management are effective in most patients. Whereas treatment options were limited many years ago for patients who failed first-line therapy, there are now multiple minimally invasive options for them. Detrusor injection of botulinum toxin, which is not yet officially approved for the treatment of idiopathic overactive bladder, significantly improves patient's symptoms and quality of life, and is well tolerated. Two types of neuromodulation are also available: posterior tibial nerve stimulation and sacral nerve stimulation. Promising new medications are in the pipeline. For those who do not respond to the minimally invasive options, augmentation cystoplasty or urinary diversion remain options.

Original languageEnglish (US)
Pages (from-to)605-613
Number of pages9
JournalExpert Review of Obstetrics and Gynecology
Issue number6
StatePublished - Nov 2012


  • augmentation cystoplasty
  • botulinum toxin
  • posterior tibial nerve stimulation
  • refractory overactive bladder
  • sacral nerve stimulation
  • treatment
  • urinary urge incontinence

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Maternity and Midwifery


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