ABSTRACT
I. INTRODUCTION The desired goal in the management of an overactive urinary sphincter is to eliminate increased or unstable reflex exciteability that leads to compromised behavior in pelvic organs and is responsible for pain and chronic urinary retention. This can be accomplished by biofeedback therapies, use of drugs such as α-adrenergic blockers-terazosin (Hytrin); prazosin (Minipress); or clonidine (Catapress) (1), or muscle relaxants (diazepam), or a combination of both. In severe pelvic pain, first-line fast relief by a symptomatic approach is mandatory. Other neurophysiological-based treatments include the use of neurotoxin (botulinum toxin A; BTX) and external or sacral neuromodulation (Fig. 1).
