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 .
Combined Vaginal Pelvic Floor Electrical Stimulation (PFS) and Local Vaginal Estrogen for Treatment of Overactive Bladder (OAB) in Perimenopausal Females. Randomized Controlled Trial (RCT).
OBJECTIVE To evaluate the efficacy of combined vaginal pelvic floor electrical stimulation ( PFS ) and local vaginal estrogen in treatment of female overactive bladder ( OAB ) . MATERIAL AND METHODS This is a r and omized controlled trial carried out on 315 perimenopausal females with OAB who were r and omly allocated into 3 equal groups . Group A underwent PFS using vaginal probes twice weekly for 12 sessions . Group B received local vaginal estrogen , whereas group C received both PFS and local estrogen . All patients were evaluated by a voiding diary , quality -of-life question naire , vaginal examination , urine analysis , blood sugar , ultrasonography , and urodynamic study before and after therapy . Patients were followed up 1 week , 3 , and 6 months post-therapy . The analyzed variables included day and night time frequency , incontinence episodes , urgency , quality of life , detrusor overactivity ) , and functional bladder capacity ) . Outcome measure was urge incontinence . RESULTS Within each group , there was a statistically significant improvement in all variables after treatment . Improvement of urgency was better in group C than in groups A and B ( P = .000 , .009 ) . Improvement of incontinence was better in groups A and C than in group B ( P = .005 , .004 ) . Follow-up showed worsening of symptoms within 6 months in all groups except incontinence in group C. CONCLUSION Vaginal PFS and estrogen found to be effective in treating OAB symptoms in perimenopausal females . Estrogen seems to augment the effect of PFS especially in the treatment of urgency incontinence and can delay its recurrence
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 .