Combination therapy studies of third-line treatments were rare and centered on medication with PTNS .
Combination therapy , with certain first , second , and third-line OAB therapies , appears to be efficacious .
AIMS Overactive bladder ( OAB ) affects over 17 % of the population and significantly effect the health-related quality of life .
The treatments for OAB include first line ( lifestyle modification , pelvic floor muscle training ) , second line ( anticholinergic or beta-3 agonist medications ) , and third line therapies ( intradetrusor botulinum toxin injection , sacral neurostimulation [ SNM ] , or percutaneous tibial nerve stimulation [ PTNS ] ) .
For those with urinary incontinence secondary to OAB , complete continence is the goal of therapy , though cure rates are only 5 % to 40 % .
The use of combination therapies can be employed in refractory OAB , however , the efficacy of pooled modalities is relatively unknown .
Our objective was to determine the volume of data supporting combination therapy in treating OAB .
Effects of Bladder Training and/or Tolterodine in Female Patients with Overactive Bladder Syndrome: A Prospective, Randomized Study
We compared the effects of bladder training and /or tolterodine as first line treatment in female patients with overactive bladder ( OAB ) . One hundred and thirty-nine female patients with OAB were r and omized to treatment with bladder training ( BT ) , tolterodine ( To , 2 mg twice daily ) or both ( Co ) for 12 weeks . Treatment efficacy was measured by micturition diary , urgency scores and patients ' subjective assessment of their bladder condition . Mean frequency and nocturia significantly decreased in all treatment groups , declining 25.9 % and 56.1 % , respectively , in the BT group ; 30.2 % and 65.4 % , respectively , in the To group ; and 33.5 % and 66.3 % , respectively in the Co group ( p<0.05 for each ) . The decrease in frequency was significantly greater in the Co group than in the BT group ( p<0.05 ) . Mean urgency score decreased by 44.8 % , 62.2 % and 60.2 % in the BT , To , and Co groups , respectively , and the improvement was significantly greater in the To and Co groups than in the BT group ( p<0.05 for each ) . Although BT , To and their combination were all effective in controlling OAB symptoms , combination therapy was more effective than either method alone . Tolterodine alone may be instituted as a first-line therapy , but may be more effective when combined with bladder training
Combination therapy studies of third-line treatments were rare and centered on medication with PTNS .
Combination therapy , with certain first , second , and third-line OAB therapies , appears to be efficacious .
AIMS Overactive bladder ( OAB ) affects over 17 % of the population and significantly effect the health-related quality of life .
The treatments for OAB include first line ( lifestyle modification , pelvic floor muscle training ) , second line ( anticholinergic or beta-3 agonist medications ) , and third line therapies ( intradetrusor botulinum toxin injection , sacral neurostimulation [ SNM ] , or percutaneous tibial nerve stimulation [ PTNS ] ) .
For those with urinary incontinence secondary to OAB , complete continence is the goal of therapy , though cure rates are only 5 % to 40 % .
The use of combination therapies can be employed in refractory OAB , however , the efficacy of pooled modalities is relatively unknown .
Our objective was to determine the volume of data supporting combination therapy in treating OAB .