Abstract

Background: overactive bladder (OAB) also referred to as the urgency-frequency syndrome, with or without urge urinary incontinence can considerably impair the patient's quality of life. It is widely accepted that diet and life style modifications, behavioral therapy and medication belong to the standard conservative therapeutic options and considered as the first-line measures. The International Consultation on Incontinence (ICI) guidelines reported that when the first line approach is not fully satisfactory or fails after 8-12 weeks, alternative therapies should be sought out. It is worthwhile and justified to proceed to second-line therapy if patients are refractory to antimuscarinic therapy or if the treatment is contraindicated. Second-line of therapies include less-invasive measures such as percutaneous posterior tibial neve stimulation, sacral neuromodulation, detrusor injections with botulinum toxin (BTX) and whereas more-invasive measures constitute surgical techniques e.g. bladder augmentation or substitution. Pelvic neuromodulation has been proven effective and is today an established treatment option for patients refractory to or intolerant of conservative treatments

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