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 .
Neuromodulative treatment of overactive bladder--noninvasive tibial nerve stimulation.
BACKGROUND Conservative treatment of overactive bladder employes behavioral or invasive neuromodulatory inhibition of miction reflex and administration of anticholinergic drugs . MAIN PURPOSE The aim of this study was to use non-invasive stimulation of the tibial nerve with the intention to achieve desired therapeutic effects without iatrogenic nerve damage using a superficial electrostimulation . METHODS All patients suffered from overactive bladder ( OAB ) without bladder outlet obstruction . OAB was examined by the Behavioral urge score BUS ( 0.0 - -the best and 1.0 - -the worst score ) , the International prostate symptom score IPSS ( 0 - -the best and 35 - -the worst score ) and the Incontinence quality of life question naire IQOL ( 0.0 - -the worst and 1.0 - -the best index ) . The patients were divided into 3 groups : Group I-- patients with electrode attached behind the medial ankle of the left lower extremity . The intensity of stimulation corresponded to 70 % of the maximum amplitude of response from musculus abductor hallucis . Frequency of stimulation was 1 Hz and duration of the square impulse was 0.1 ms . Surface stimulation lasted 30 minutes and was repeated once a week . Group II-- patients were treated by oral oxybutynin 5 mg t.i.d . Group III-- patients without treatment . The BUS , IPSS , and IQOL were repeated after the treatment . RESULTS The study included 28 females of average age 54 year ( range 45 to 63 ) . Mean IPSS was 17 ( range 12 to 21 ) , mean index of quality of life IQOL was 30 ( range 12 to 78 ) and mean BUS score was 0.68 ( range 0.50 to 0.86 ) . Group I with stimulation did achieve statistically significant changes following the treatment : decrease of mean IPSS from 17 + /- 3 points to 6 + /- 4 points after the treatment , increase in mean IQOL from 36 + /- 10 to 68 + /- 20 and decrease of mean BUS from 0.65 + /- 0.12 to 0.43 + /- 0.16 . Group II had similar statistically significant differences after the treatment of OAB . Group III noted no changes in the complaints . CONCLUSION Noninvasive stimulation had improved subjective symptom related to overactive bladder , had no adverse events and was well tolerated . ( Fig. 1 , Tab . 1 , Ref . 18 . )
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 .