Recent Non-neurogenic Overactive Bladder Trials

Abstract

We sought to address the most important trials regarding overactive bladder (OAB) syndrome published in the past 5 years regarding pharmacological treatment and minimally invasive procedures (botulinum toxin A, percutaneous tibial nerve stimulation, and sacral neuromodulation). Most of the randomized controlled trials related to OAB are studying anticholinergics and/or beta-adrenergics versus each other or to a placebo-comparator group. Studies have shown stability of using mirabegron and that combination therapy (anticholinergics plus beta-adrenoceptors) seems a good choice for patients with OAB. Percutaneous tibial nerve stimulation needs further studies with comparators to confirm its role. Regarding intra-vesical botulinic toxin or sacral neuromodulation for OAB, both options present good percentages of patient improvement, with no clinically significant difference between them to this moment. Despite a growing number of high-quality randomized trials on OAB, further studies are needed comparing different lines of treatment for this disease.