title: [Update on the second line management of idiopathic overactive bladder].
abstract: The overactive bladder syndrome (OAB) negatively affects the daily life of many people worldwide and conservative treatments, such as antimuscarinics, not always bring relief and/or are associated with considerable side effects resulting in treatment failure. Second line treatment options used to be invasive surgical procedures. However, less radical, minimally invasive and reversible alternatives, such as sacral neuromodulation and botulinum toxin A have emerged. Of these, only sacral neuromodulation with InterStim Therapy has been approved for OAB and been recommended by the International Consultation on Incontinence (ICI) in 2004. Nevertheless, depending of country rules and habits, both seem to be used by urologists in clinical practice for treating idiopathic OAB (I OAB). Therefore, this review attempts to provide an update on the available clinical evidence concerning the efficacy and safety, and the current position of sacral neuromodulation and botulinum toxin A in the second line management of adults with I OAB.
authors.affiliation: Service d'urologie, groupe hospitalier Pitié-Salpêtrière, faculté de médecine Pierre-et-Marie-Curie, université Paris-VI, 83, boulevard de l'Hôpital, 75013 Paris, France. emmanuel.chartier-kastler@psl.aphp.fr
authors.forename: E
authors.initials: E
authors.lastname: Chartier-Kastler
authors.forename: D
authors.initials: D
authors.lastname: Castro-Diaz
authors.forename: D
authors.initials: D
authors.lastname: De Ridder
authors.forename: K
authors.initials: K
authors.lastname: Everaert
authors.forename: K D
authors.initials: KD
authors.lastname: Sievert
authors.forename: M
authors.initials: M
authors.lastname: Spinelli
authors.forename: P
authors.initials: P
authors.lastname: van Kerrebroeck
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D004599:Electric Stimulation Therapy; D006801:Humans; D009465:Neuromuscular Agents / Q000627:therapeutic use; D053201:Urinary Bladder, Overactive / Q000628:therapy*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A