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Symptoms of urgency and frequency, with or without incontinence, are collectively referred to as overactive bladder (OAB), that is particularly bothersome and worsens quality of life (QOL) (Cardozo et al., 2005). Patients’ QOL is substantially impacted by OAB as social, psychological, occupational, domestic, physical, and sexual functioning are all affected (Abrams et al., 2000). Pharmacotherapy (anticholinergics) is the main treatment options in OAB. However, uncertainty still exists as to whether the effects of anticholinergics are worthwhile and which ones and which is the best route of administration. Neuromodulation is one of the non-drug alternatives of OAB managements like bladder training, pelvic floor muscle training (PFMT), and a combination of bladder training with biofeedback (Bergmans et al., 2005). Neuromodulation involves the use of either implanted or external electrodes to stimulate reflex inhibition of pelvic efferents or activation of hypogastric efferents to down regulate detrusor muscle activity (Alhasso et al., 2006). But, neuromodulation has not been widely accepted as first-line therapy because of few physiological and evidence based data. Patients with OAB are commonly treated using anticholinergics despite many adverse events (mainly dry mouth and constipation) (Abrams et al., 2006), possible poor medication adherence, and insufficient treatment satisfaction.

Neuromodulation in Management of Overactive Bladder