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The Evaluation and Management of Refractory Neurogenic Overactive Bladder

  • Lower Urinary Tract Symptoms & Voiding Dysfunction (H Goldman and G Badlani, Section Editors)
  • Published:
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Abstract

Patients with neurologic disease commonly develop overactive bladder (OAB) symptoms of urgency, frequency, and/or urge incontinence that remain bothersome despite oral pharmacologic therapy. Management of refractory OAB in the neurogenic population is a complex issue with no uniform treatment strategy. When treatment fails or patients generally are dissatisfied with the adverse effects of oral therapy, available options include sacral neuromodulation, percutaneous tibial nerve stimulation (PTNS), botulinum toxin injections, and lower urinary tract reconstruction such as augmentation cystoplasty. A thorough knowledge and understanding of available and emerging treatment options for neurogenic detrusor overactivity is paramount to assisting clinicians in choosing an appropriate treatment. This article reviews the non-pharmacologic treatment options for neurogenic OAB, mainly botulinum toxin, neuromodulation, and lower urinary tract reconstruction, and discusses important relevant studies.

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Conflict of Interest

Dr. Raj Kurpad declares no potential conflicts of interest.

Dr. Michael J. Kennelly reports grants and personal fees from Allergan, Medtronic, and Uroplasty, as well as grants from Hollister, Coloplast, and Bard.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Urology, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC, USA

    Raj Kurpad

  2. McKay Department of Urology, Carolinas Medical Center, 1023 Edgehill Road South, Charlotte, NC, 28207, USA

    Michael J. Kennelly

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  1. Raj Kurpad
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  2. Michael J. Kennelly
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Correspondence to Michael J. Kennelly.

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This article is part of the Topical Collection on Lower Urinary Tract Symptoms & Voiding Dysfunction

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Kurpad, R., Kennelly, M.J. The Evaluation and Management of Refractory Neurogenic Overactive Bladder. Curr Urol Rep 15, 444 (2014). https://doi.org/10.1007/s11934-014-0444-z

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  • DOI: https://doi.org/10.1007/s11934-014-0444-z

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