Refractory Overactive Bladder: How to Select 3rd-Line Therapies and Optimize Outcomes (2022) CME Available: https://auau.auanet.org/node/36033 LEARNING OBJECTIVES At the conclusion of this course, participants will be able to: 1. Describe the various 3rd line therapies available to treat refractory overactive bladder (OAB) and be able to discuss the pros and cons of each of the 3rd line therapies available to treat refractory OAB. 2. Explain with the current data regarding outcomes of percutaneous tibial nerve stimulation (PTNS), onabotulinumtoxinA and sacral neuromodulation for treatment of refractory OAB. 3. Outline how to perform PTNS. 4. Report how to perform onabotunlinumtoxinA injections in the office or outpatient setting.. 5. Review techniques in optimal lead placement for sacral neuromodulation, programming and troubleshooting.