Pelvic floor exercises are more effective in subjective and objective outcomes with biofeedback or verbal feedback .
Weight loss with diet and exercise , caffeine reduction , 25 - 50 % reduction in fluid intake , and pelvic floor muscle exercises with verbal instruction and or biofeedback were all efficacious .
Botulinum toxin A improves urge incontinence episodes , urgency , frequency , quality of life , nocturia , and urodynamic testing parameters .
Acupuncture  improves quality of life and urodynamic testing parameters .
Extracorporeal magnetic stimulation improves urodynamic parameters .
Mirabegron improves daily incontinence episodes , nocturia , number of daily voids , and urine volume per void , whereas solabegron improves daily incontinence episodes .
Short-term posterior tibial nerve stimulation is more efficacious than pelvic floor muscle training exercises and behavioral therapy for improving : urgency , urinary incontinence episodes , daily voids , volume per void , and overall quality of life .
Sacral neuromodulation is more efficacious than antimuscarinic treatment for subjective improvement of overactive bladder and quality of life .
Transvaginal electrical stimulation demonstrates subjective improvement in overactive bladder symptoms and urodynamic parameters .
Multiple therapies , including physical therapy , behavioral therapy , botulinum toxin A , acupuncture , magnetic stimulation , mirabegron , posterior tibial nerve stimulation , sacral neuromodulation , and transvaginal electrical stimulation , are efficacious in the treatment of overactive bladder
The purpose of the study was to determine the efficacy and safety of nonantimuscarinic treatments for overactive bladder .
Repeated botulinum toxin type A injections for refractory overactive bladder: medium-term outcomes, safety profile, and discontinuation rates.
BACKGROUND Efficacy and safety of botulinum toxin type A ( BoNTA ) injection is supported by level 1 evidence , but data regarding repeated injections are limited in patients with refractory overactive bladder ( OAB ) and idiopathic detrusor overactivity ( IDO ) . OBJECTIVES Describe medium-term outcomes and discontinuation rates for patients adopting repeated BoNTA as a management strategy for IDO . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve data from a single centre were collected from the first 100 patients . INTERVENTION Bladder injection of BoNTA ( predominantly 200 U onabotulinumtoxinA ; Allergan Ltd. , Marlow , Buckinghamshire , UK ) in an outpatient setting . MEASUREMENTS OAB symptoms , quality of life , discontinuation rates , interinjection interval , and adverse events were recorded . Data comparisons were performed using a generalised linear model or a chi-square test where appropriate . RESULTS AND LIMITATIONS Two hundred seven injections were performed in 100 patients . All patients had 1 injection , 53 had a total of 2 , 20 had 3 , 13 had 4 , 10 had 5 , 5 had 6 , 3 had 7 , 1 had 8 , 1 had 9 , and 1 had 10 injections . Statistics were applied up to five repeated injections . A statistically significant reduction in frequency , urgency , and urge urinary incontinence were seen following the first BoNTA injection compared to baseline . This improvement was maintained after repeated injections and was not statistically different when comparing differences between injections . Thirty-seven patients stopped treatment after the first two injections ; thereafter , dropouts were rare . The most common reasons for discontinuing treatment were poor efficacy ( 13 % ) and clean intermittent self-catheterisation (CISC)-related issues ( 11 % ) . The incidence of CISC after the first injection was 35 % . Bacteriuria was detected in 21 % of patients . The mean interinjection interval was 322 d. Limitations included the concurrent use of antimuscarinic drugs in some patients . CONCLUSIONS BoNTA can provide a safe and effective medium-term management option for patients with refractory IDO . The most common reasons cited for stopping treatment were poor efficacy and CISC-related issues
Pelvic floor exercises are more effective in subjective and objective outcomes with biofeedback or verbal feedback .
Weight loss with diet and exercise , caffeine reduction , 25 - 50 % reduction in fluid intake , and pelvic floor muscle exercises with verbal instruction and or biofeedback were all efficacious .
Botulinum toxin A improves urge incontinence episodes , urgency , frequency , quality of life , nocturia , and urodynamic testing parameters .
Acupuncture  improves quality of life and urodynamic testing parameters .
Extracorporeal magnetic stimulation improves urodynamic parameters .
Mirabegron improves daily incontinence episodes , nocturia , number of daily voids , and urine volume per void , whereas solabegron improves daily incontinence episodes .
Short-term posterior tibial nerve stimulation is more efficacious than pelvic floor muscle training exercises and behavioral therapy for improving : urgency , urinary incontinence episodes , daily voids , volume per void , and overall quality of life .
Sacral neuromodulation is more efficacious than antimuscarinic treatment for subjective improvement of overactive bladder and quality of life .
Transvaginal electrical stimulation demonstrates subjective improvement in overactive bladder symptoms and urodynamic parameters .
Multiple therapies , including physical therapy , behavioral therapy , botulinum toxin A , acupuncture , magnetic stimulation , mirabegron , posterior tibial nerve stimulation , sacral neuromodulation , and transvaginal electrical stimulation , are efficacious in the treatment of overactive bladder
The purpose of the study was to determine the efficacy and safety of nonantimuscarinic treatments for overactive bladder .