Medicinal plants and natural products for treating overactive bladder

Chinese Medicine

Table 1 Therapy options for OAB [1, 94]

Level of therapy	Route	Treatment	Proposed mechanism of action
First-line therapy	Behavioral	Avoidance of bladder irritants, bladder retraining, pelvic floor physical therapy and biofeedback	Decreases irritation
Second-line therapy	Oral	Antimuscarinics	Suppresses detrusor muscle contractions
	Transdermal	Beta-3 Agonist	Relaxes detrusor smooth muscle
	Transdermal	Antimuscarinics	Suppresses detrusor muscle
Third-line therapy*	Neuromodulation	Sacral neuromodulation (SNS)	Unknown, electrically activates somatic afferent nerves in spinal nerve root
	Neuromodulation	Percutaneous tibial nerve stimulation (PTNS)	Unknown, electrically activates somatic afferent nerves in spinal nerve root
	Intravesical	Intradetrusor onabotulinumt oxin A (Botox^®) injection	Paralyzes detrusor muscle

*May be offered to carefully selected patients who have failed first-line and second-line therapy, or who are not able to tolerate medications due to contraindications or adverse effects

ISSN: 1749-8546