Dr. MacDiarmid is Associate Professor, Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC. He serves as an advisor to Ortho-McNeil Pharmaceuticals and Watson Pharmaceuticals.
This article provides a real-world definition of refractory overactive bladder and its prevalence, then examines treatment options, with a focus on percutaneous tibial nerve stimulation as a noninvasive form of neuromodulation “for the masses.”
Consider mixed urinary incontinence in the differential diagnosis of patients who present with symptoms of urge incontinence. Left untreated, this under-recognized condition places patients at increased risk for medical complications and adversely affects their quality of life. Medical therapy in conjunction with behavioral modification is a reasonable first-line management option.