Current Urology Reports

, 15:444 | Cite as

The Evaluation and Management of Refractory Neurogenic Overactive Bladder

Lower Urinary Tract Symptoms & Voiding Dysfunction (H Goldman and G Badlani, Section Editors)
First Online:
Part of the following topical collections:
  1. Topical Collection on Lower Urinary Tract Symptoms & Voiding Dysfunction

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.

Keywords

Neurogenic bladder Neurogenic detrusor overactivity Spinal cord injury Botulinum toxin Neuromodulation Lower urinary tract reconstruction 
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Notes

Compliance with Ethics Guidelines

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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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of UrologyUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.McKay Department of UrologyCarolinas Medical CenterCharlotteUSA

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