Additional therapies, including Botox and implanted neuromodulation systems, may be appropriate for some patients when earlier treatments have not provided satisfactory results.

Botox injections into the bladder

• Commonly used for OAB.
• Not surgery in the traditional sense.
• Usually performed in a physician's office or procedure setting.
• Temporary and repeatable.

Sacral Neuromodulation

• Implanted systems stimulate nerves near the sacrum instead of the tibial nerve.
• Requires an implanted device.
• Usually considered after less invasive approaches.