To compare the efficacy and safety of different interventions (including Antimuscarinics, Mirabegron, OnabotulinumtoxinA, sacral neuromodulation (SNM) and peripheral tibial nerve stimulation (PTNS)) on idiopathic overactive bladder (OAB). PubMed, Embase, Cochrane library, and other sources were searched for randomized controlled trials (RCTs) comparing interventions of OAB from 1 January 2000 to 19 April 2021. A systematic review and network meta-analysis were performed by two authors

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... tly. 55 RCTs involving 32,507 patients were included in this network. Overall, Antimuscarinics, Mirabegron, OnabotulinumtoxinA, SNM, and PTNS were more efficacious than placebo and SNM showed the best effect for reducing micturition frequency, urgency episodes and urgency urinary incontinence episodes. OnabotulinumtoxinA was the best in achieving reduction of 100% and ≥50% in the number of urinary incontinence episodes /day and PTNS was the best in reducing urinary incontinence episodes. The efficacy of Antimuscarinics, Mirabegron and PTNS were similar in reducing micturition frequency, urinary incontinence episodes and urgency urinary incontinence episodes. The results revealed that all interventions included in the network were efficacious in managing adult OAB syndrome compared with placebo. Furthermore, SNM and OnabotulinumtoxinA were the most efficient treatments for overactive bladder.