{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:44:31Z","timestamp":1791045871226,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Patients with overactive bladder (OAB) refractory to first\u2010 and second\u2010line therapy may pursue third\u2010line therapies, including intradetrusor onabotulinum toxin\u2010A (BTX), peripheral tibial nerve stimulation (PTNS), and sacral neuromodulation (SNM). The factors that influence patient preference for each treatment modality have not yet been explored. This study sought to investigate the specific parameters that patients consider in choosing a third\u2010line therapy for OAB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients refractory to first\u2010 and second\u2010line therapies for OAB were identified in our outpatient clinic and asked to watch an educational video providing information on the risks and benefits of each third\u2010line treatment option. They were then given a questionnaire to rank their preference of therapy and select reasons for why they found each therapy favorable and unfavorable. Patients under age 18 years, non\u2010English speakers, those with a developmental disability, and those with a diagnosis of neurogenic bladder were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 98 patients included in the study, 40 participants (40.8%) chose intradetrusor BTX injections, 34 (34.7%) chose PTNS, and 16 (16.3%) chose SNM as their first choice. Seven patients (7.1%) chose none of the offered therapies, and one patient (1.0%) chose all three therapies with equal preference. BTX was found most attractive for its long efficacy (47%); its least attractive feature was the potential need for self\u2010catheterization due to urinary retention (54%). PTNS was found most attractive for being a nonsurgical option (32%) and having no reported significant complications (39%); its least attractive feature was need for frequent office visits (61%). SNM was found most attractive for its potential for long\u2010term relief without frequent office visits (53%); its least attractive feature was need for an implanted device (33%). Patients opting for SNM had higher scores on Urinary Distress Inventory\u20106\u00a0and Incontinence Impact Questionnaire\u20107 questionnaires when compared to patients opting for BTX injections or PTNS (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). 47.4% of patients eventually pursued a third\u2010line therapy. Of those, there was a 67.6% concordance rate between the therapy patients ranked first and the therapy they eventually underwent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with more severe OAB symptoms opt for more invasive and less time\u2010consuming therapy with the potential for long\u2010term relief, namely SNM. Despite thorough counseling, many patients do not progress to advanced OAB therapies. Understanding factors that influence patients' affinity toward\u00a0a specific type of treatment can aid with individualized counseling on third\u2010line OAB therapies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25046","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T04:33:15Z","timestamp":1663216395000},"page":"1906-1913","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["An analysis of factors that influence patient preference of third\u2010line therapy for overactive bladder"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6982-4329","authenticated-orcid":false,"given":"Anjali","family":"Kapur","sequence":"first","affiliation":[{"name":"Department of Urology Stony Brook University Medical Center  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arshia Aalami","family":"Harandi","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tal","family":"Cohen","sequence":"additional","affiliation":[{"name":"The New York Institute of Technology College of Osteopathic Medicine  Glen Head New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Ruan","sequence":"additional","affiliation":[{"name":"Department of Urology Stony Brook University Medical Center  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Dabrowski","sequence":"additional","affiliation":[{"name":"Staten Island University Hospital  Staten Island New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3862-871X","authenticated-orcid":false,"given":"Rebecca","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Urology Division, Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuemin","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Urology, Houston Methodist Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Lee","sequence":"additional","affiliation":[{"name":"Renaissance School of Medicine at Stony Brook University  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0008-2785","authenticated-orcid":false,"given":"Steven","family":"Weissbart","sequence":"additional","affiliation":[{"name":"Department of Urology Stony Brook University Medical Center  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Urology Stony Brook University Medical Center  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-009-0976-9"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2010.08.039"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-002-0301-4"},{"key":"e_1_2_9_5_1","first-page":"40","volume-title":"Overactive Bladder: Utilization of Third Line Therapies","author":"Rourke EK S","year":"2021"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2004.07.042"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1998.tb10024.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2018.05.004"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24618"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24915"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000001950"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000309"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.1930140206"},{"key":"e_1_2_9_14_1","unstructured":"US Census Bureau.\u00a0ACS 5\u2010 Year Estimates Median Income. 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