Management of refractory overactive bladder in adults.

Urologists experience frustration in the treatment of refractory overactive bladder for a multitude of reasons. Clinical failure experienced in managing these patients can lead to long office interactions and feelings of inadequacy for both patient and provider. With newer, technically straightforward interventions, this population can be approached with confidence. Appropriately timed diagnostics are essential in identifying neoplastic, neurogenic, and infectious causes for refractory overactive bladder. When approached in an efficient, stepwise fashion, outcomes can be highly satisfactory for both the patient and the provider.