The overactive bladder (OAB) syndrome is the main cause of urge incontinence and urgency (generally associated with detrusor overactivity). Approximately 35 of patients with detrusor overactivity are unresponsive to current Antimuscarinic drugs. These “refractory” patients are a hard-core group of sufferers constantly expending health care resources in their search for relief. Recent studies find bacterial cystitis in approximately 30-50 of DO patients refractory to treatment. This workshop will bring together clinicians and scientists to discuss the recent findings on recurrent bacterial cystitis and reasons for antibiotic resistance in relation to the refractory state.