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Treatment of Overactive Bladder Refractory to Medications

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Minimally Invasive Therapy for Urinary Incontinence and Pelvic Organ Prolapse

Part of the book series: Current Clinical Urology ((CCU))

Abstract

Conservative therapy for overactive bladder (OAB) has been shown to be a viable stand alone or adjunctive option to antimuscarinic agents (AMAs). Typically nonsurgical options such as behavioral therapy, pelvic floor muscle therapy (PFMT), and biofeedback have been recommended prior to more invasive options such as electrical stimulation, intravesical Botox, or augmentation enterocystoplasty, ileovesicostomy, and urinary diversion. We believe this standard step-wise algorithmic approach to treatment is reasonable, but in some instances may subject patients to unnecessary expense and delay in treatment. Rather, we prefer to individualize our approach to maximize the likelihood of success in each patient while appropriately weighing relative risks with potential benefits. So, for example, a patient with severe neurogenic OAB refractory to AMA may opt for augmentation cystoplasty rather than intradetrusor injection of Botox or neuromodulation.

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Authors and Affiliations

  1. Department of Urology, Weill Cornell Medical College of Cornell University, 445 E. 77th Street, New York, NY, 10075, USA

    Rajveer S. Purohit M.D., M.P.H. & Jerry G. Blaivas M.D.

  2. Department of Urology, SUNY Downstate College of Medicine, Brooklyn, NY, USA

    Jerry G. Blaivas M.D.

  3. Institute for Bladder and Prostate Research, New York, NY, USA

    Jerry G. Blaivas M.D.

Authors
  1. Rajveer S. Purohit M.D., M.P.H.
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  2. Jerry G. Blaivas M.D.
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Corresponding author

Correspondence to Rajveer S. Purohit M.D., M.P.H. .

Editor information

Editors and Affiliations

  1. Department of Urology, Wake Forest University, Winston-Salem, North Carolina, USA

    Gopal H. Badlani

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Purohit, R.S., Blaivas, J.G. (2014). Treatment of Overactive Bladder Refractory to Medications. In: Badlani, G. (eds) Minimally Invasive Therapy for Urinary Incontinence and Pelvic Organ Prolapse. Current Clinical Urology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-0008-4_11

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  • DOI: https://doi.org/10.1007/978-1-4939-0008-4_11

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  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-0007-7

  • Online ISBN: 978-1-4939-0008-4

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