Key Points

Treatment principles Treatment options for OAB are divided by “lines of therapy” based on levels of invasiveness; First line includes lifestyle modifications and pelvic floor physical therapy; Second line consists of drug therapy with anticholinergics and/or beta-3 agonists; Third line includes intravesical botulinum toxin injection, SNM* and PTNS**; Treatment should ideally escalate from least to most invasive, but different modalities can be combined if single-therapy approach is not successful.