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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 thedoi:10.4172/2167-0846.1000334 fatcat:bpfr5fjhjbga5d7q5e43z36jm4