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 .
The outcome of adding peripheral neuromodulation (stoller afferent neuro-stimulation) to anti-muscarinic therapy in women with severe overactive bladder
Objective . Anti-muscarinic treatment alone and peripheral neuromodulation with concomitant anti-muscarinic treatment were compared in patients with severe overactive bladder . Methods . In this prospect i ve study , 40 women with severe overactive bladder according to the 7-day voiding diary without any prior treatment completed the Incontinence Impact Question naire ( IIQ-7 ) and were r and omised into anti-muscarinic-alone and combination treatment groups . Twenty women received daily 4 mgs of tolterodine orally and in 20 women Stoller afferent neuro-stimulation ( SANS ) therapy was performed concomitantly for 12 weeks to the same anti-muscarinic regimen . After 12 weeks of therapy , two of the patients drop out of the study and remaining patients filled out the IIQ-7 question naire and the 7-day voiding diary again . Pretreatment and post-treatment QoL scores and the 7-day voiding diaries were compared . Mann – Whitney U , Wilcoxon and two sided significance tests were used . Results . Thirty-eight women fulfilling the criteria were included in the study .  Severity of overactive bladder symptoms decreased significantly in both treatment groups . However , the decrease in combination treatment group was more significant than the anti-muscarinic-alone group . Adverse events were similar between the two groups . Conclusion . Combining SANS and anti-muscarinic therapy result ed in significantly better clinical outcomes and IIQ-7 scores as compared with anti-muscarinic treatment alone in patients with severe overactive bladder
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 .