Introduction: Persistence and adherence rates assessed for various drugs for Overactive Bladder (OAB) in real-world settings are dramatically poor, with almost 70% to 90% of patients discontinuing treatment within 1 year. We investigated the clinical outcomes of second-line treatments in a group of patients with wet-OAB, who then switched to Onabotulinumtoxin A (Onabot/A) intradetrusorial injections. Patients’ discontinuation to treatment and the reasons why patients stopped their oral medications were also investigated. Comparisons with the clinical outcomes and satisfaction to treatment obtained with Onabot/A intradetrusor injections in the same patients were also assessed. Patients and Methods: The outpatient visits charts of 125 wet OAB patients treated with secondline oral agents, who then switched to Onabotulinum toxin A intradetrusor injections, were retrospectively reviewed. We assessed the number and types (immediate or long-acting formulations) of anticholinergics (ACHs) cycled, the use of Mirabegron oral therapy, and persistence to these pharmacological agents since the beginning of treatment until patients switched to Onabot/A intradetrusor injections. Patients were classified as having tried 1, 2, or =3 anticholinergics, alone or in combination with Mirabegron, or Mirabegron oral treatment alone. Daily frequency of Urinary Incontinence (UI), as recorded by the 3-day voiding diary and satisfaction to treatment, as scored by a Visual Analog Scale (VAS), both obtained at the last evaluation before being included in the neurotoxin treatment regimen, were retrospectively analyzed. Any eventual side effect due to ACHs and/or Mirabegron treatment was also noted. Daily frequency of urinary incontinence episodes and satisfaction to treatment, as well as rates of discontinuation and side effects, has been investigated in the same patients following Onabot/A intravesical treatment.