Initial Office Evaluation for OAB Urinary Incontinence, Urgency, Frequency& Nocturia Conservative Treatments Fluid & Irritant Reduction, Timed Voiding, Physical Therapy eCoin Placement 1st Line Trial of TENS Therapy or Oral Medication Samples TENS Unit for 1 week twice a day for 30 minutes: No Side Effects Beta Agonist for 4 Weeks  Rare Side Effects: HTN, Headaches Anticholinergic for 2 weeks  Common Side Effects: Dry Mouth, Dry Eyes, Constipation Re-Evaluation in the Office Assess Experience and change in Bladder Symptoms Decide on Therapy Plan *eCoin Tibial Implant* 20 minute procedure to implant a nickel sized device at the ankle Automatically stimulates the tibial nerve for bladder control Device exchanged after 3 to 5 years of therapy Urgent PC Therapy Clinic Treatment 12 Weekly Visits 30 Minute Sessions at Ankle InterStim Lead Surgery 2 Part Outpatient Surgery 2 Week Sacral Stimulation trial Botox Injection Clinic Procedure Cystoscopic needle delivery Retention and UTI risk Discomfort with Injections Pacemaker Placement Hardware placed at buttock Battery lasts about 5 to 7 years Surgical exchange Management of device remote No MRIs below the neck Maintenance Treatments 30 minute sessions monthly Time Consuming Repeat Procedures Usually every 6 to 11 months