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6: Intractable Overactive Bladder- Advanced Management Strategies

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    • 6.1: Introduction
      The mainstay of treatment for Overactive Bladder is fluid management, bladder retraining and anticholinergic drug therapy. There are, however, a subset of women who do not respond to these standard treatment regimens and remain incontinent, their symptoms having a profound impact on their quality of life.
    • 6.2: Botulinum Toxin
      Botulinum Toxin, which is produced by the bacterium, Clostridium Perfringens, is the most potent toxin known to man.
    • 6.3: Sacral Nerve Stimulation (SNS)
      This device works by implanting a pacemaker-like neurostimulator in the lower back that sends mild electrical impulses to electrodes that are usually placed adjacent to the third sacral nerve root.
    • 6.4: Posterior Tibial Nerve Stimulation
      Because of the technical and cost implications of SNS, indirect neuromodulation of S2,3 and 4 via stimulation of the posterior tibial nerve, was developed.
    • 6.5: 6.5-Surgical Therapy
      Clam ileocystoplasty and augmentation procedures are usually reserved for patients with neurogenic detrusor overactivity and high pressure bladders with the potential of upper tract damage.
    • 6.6: Alternative therapy
      A number of studies have shown acupuncture to be a useful adjunct to therapy.

    This page titled 6: Intractable Overactive Bladder- Advanced Management Strategies is shared under a CC BY-NC-SA 2.5 license and was authored, remixed, and/or curated by Stephen Jeffery and Peter de Jong via source content that was edited to the style and standards of the LibreTexts platform; a detailed edit history is available upon request.