For evolving strategies to effectively address the growing number of refractory cases of OAB, they must have widespread, practical application that translates therapeutic effectiveness to the patient as defined by clinical efficacy, tolerability, and persistence. Although many options seem limited in scope or complex in application, most are inspirational to specialists seeking optimal outcomes for people with refractory and complex conditions. The available strategies outlined above are a reflection of our current understanding of the pathophysiology of OAB and attendant refractory conditions. The promise for future successful strategies lies not only in the successful translation of our basic science knowledge of the OAB to date, but advancement of our basic and clinical science research of refractory conditions for the future.

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