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Daniel Gallego Vilar, Gonzalo Garcia-Fadrique, Jose Beltran-Persiva and Mateo Perez-Mestre
Patients with BPS persistent and unacceptable symptoms despite oral and/or intravesical therapy are candidates for more aggressive modalities. Many of these are best administered within the context of a clinical trial if possible. These may include: neuromodulation, intradetrusor botulinum toxin, oral cyclosporine and other anesthesic techniques. The last step in treatment is usually some type of surgical intervention aimed at increasing the functional capacities of the bladder or diverting the urinary stream. In this paper a review of interventional treatment´s clinical evidence is made and shows how to improve symptoms in refractory BPS.