Key inclusion criteria
Patients will be female, over 50 years of age who present with a main complaint of urge incontinence.
Urodynamic testing will show a primary diagnosis of detrusor overactivity (DO).
Patients will have failed to respond to bladder training with at least 2 anti-muscarinic therapeutic agents over 2 years.
Participants must leak urine at least 1 episode per 3 days on frequency volume chart.
Key exclusion criteria
a. Neuropathic DO (such as multiple sclerosis, spinal cord injury, Parkinsonism) b. Voiding dysfunction, defined as urinary flow rate less than 15 ml per sec for volume greater than 200ml with residual volume greater than 100ml c. Insufficient English language skills, or dementia, ie unable to complete questionnaires unaided. d. elevated creatinine, renal failure, e. allergy to more than penicillin