title: Update on the treatment of overactive bladder.
abstract: OBJECTIVE
  As overactive bladder (OAB) is a prevalent and chronic medical condition that greatly impacts an individual's quality of life, novel therapeutic options are always welcome.
  
  
  RESULTS
  Recent evidence suggests that newer antimuscarinic agents are not only superior to placebo, but may also have a role in treating OAB symptoms in children and men with lower urinary tract symptom. Dose escalation for trospium and fesoterodine has shown to be both efficacious and safe. Adverse events typically exceed those of placebo but infrequently lead to cessation of therapy. Long-term outcomes of sacral nerve stimulation for refractory OAB have been recently reported. Although the overall satisfaction with this therapy is high, more than 50% may experience chronic pain; however, this adverse event also does not frequently lead to device removal. Percutaneous tibial nerve stimulation continues to display superiority to sham treatment and benefits similar to antimuscarinic therapy may be observed. This therapy is well tolerated and durable outcomes have been seen at 12 months of follow-up. Recent evidence suggests that a dose of 100 U per botulinum neurotoxin type A injection may optimally balance symptom improvement and incidence of voiding difficulty.
  
  
  CONCLUSIONS
  Treatment modalities for OAB continue to evolve and the abundance of options can only benefit the individuals with this condition.
authors.affiliation: Department of Urology, Louisiana State University Medical Center, Shreveport, LA, USA. roger.dmochowski@Vanderbilt.edu
authors.forename: Roger R
authors.initials: RR
authors.lastname: Dmochowski
authors.forename: Alex
authors.initials: A
authors.lastname: Gomelsky
mesh_terms: D019274:Botulinum Toxins, Type A / Q000009:adverse effects / Q000627:therapeutic use*; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D006801:Humans; D008160:Lumbosacral Plexus / Q000503:physiopathology; D018727:Muscarinic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D018579:Patient Selection; D013979:Tibial Nerve / Q000503:physiopathology; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000503:physiopathology / Q000628:therapy*
chemical_list: D018727:Muscarinic Antagonists; D019274:Botulinum Toxins, Type A