What are 3rd line tx of UUI?

If patients with urge incontinence meet the following criteria, they are eligible for third-line treatment (refractory cases): 1) They demonstrate a failure of response to behavioral therapy, and 2) They have either intolerance to or inadequate response to at least two second-line treatments. Third-line treatment includes Percutaneous stimulation of tibial nerve (PTNS), temporary chemical denervation of the bladder detrusor muscle, and sacral neuromodulation. Third-line treatment includes also Intravesical onabotulinum toxin A injection requires delivery via cystoscopy every six months if symptoms recur. It results in flaccid paralysis of the detrusor muscle with consistent improvement in urge incontinence symptoms and quality of life