Behavioural approaches are helpful in overactive bladder

Editor—Herbison et al made a plea for a more pragmatic approach to evaluating patients with an overactive bladder syndrome.1 A strong criticism of the work performed to date relates to the use of placebo as a control. They argue for the use of a behavioural approach such as bladder retraining as a comparator. This seems logical given that behavioural approaches are offered to most people with lower urinary tract symptoms (many of which will have overactive bladders) as a first line of treatment. Behavioural approaches might prove more effective for longer and lack the harms associated with pharmacotherapy.