A Review of Minimally Invasive Therapies for Men with Overactive Bladder

This manuscript aims to provide an overview of minimally invasive treatment for overactive bladder (OAB) in men, highlighting how concomitant bladder outlet obstruction in men can complicate management and lead to underutilization of these therapies in this patient population.

The 2024 AUA/SUFU guidelines now allow practitioners to offer minimally invasive therapy as an upfront treatment for OAB. Recent studies have closely examined the efficacy of several key procedures, including intradetrusor onabotulinumtoxin-A (BTX-A), sacral neuromodulation (SNM), and tibial nerve stimulation via percutaneous or implantable devices. All three modalities are effective in terms of improving OAB symptoms, however the evidence base is largely female-derived.  This highlights the ongoing need for adequately powered, male-specific clinical trials to address this disparity and help guide individualized treatment planning.