By vgreene, 23 December, 2014 If severe, refractory, complicated OAB: in extremely rare cases, consider augmentation cystoplasty or urinary diversion [EO]
By vgreene, 23 December, 2014 Sacral neuromodulation in pts w/ severe refractory OAB, or if pt not a candidate for 2nd-line drug tx and is willing to undergo surgery [R/C]
By vgreene, 23 December, 2014 Intradetrusor onabotulinumtoxinA (100U) in pts willing/able to return for freq PVRs and self-cath if needed [S-O/B-C]
By vgreene, 23 December, 2014 If refractory<sup>9</sup> to behavioral<sup>10</sup> and drug tx:<sup>11</sup> specialist eval if additional tx desired [EO]. Consider UCx, PVR, bladder diary/sx questionnaire, etc.
By vgreene, 23 December, 2014 Presenting w/ OAB s/sx (urgency, frequency, nocturia, urge-incontinence)
By vgreene, 23 December, 2014 2nd-line options<sup>4</sup> w/ active management of ADEs<sup>2,4,5,6,7</sup>
By vgreene, 23 December, 2014 If refractory to behavioral and drug tx:<sup>2</sup> eval by specialist if additional tx desired [EO]. Consider UCx, PVR, bladder diary/sx questionnaire, etc.
By vgreene, 23 December, 2014 If inadequate sx control<sup>2</sup> and/or unacceptable ADE w/ 1 antimuscarinic:<sup>5,6</sup> manage constipation/dry mouth,<sup>4</sup> modify dose, or try a different antimuscarinic or a β3-adrenoceptor agonist (mirabegron). [CP]
By vgreene, 23 December, 2014 Offer oral antimuscarinics<sup>5,8</sup> or β3-adrenoceptor agonists (mirabegron) [S/B]. Transdermal oxybutynin patch/gel OTC<sup>8</sup> may be offered. [R/C]