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The Efficacy of Intradetrusor Onabotulinumtoxin A Injection for Refractory Overactive Bladder Syndrome-A
Chie Nakai1, Kosei Miwa1, Yasuhide Kitagawa2
1Department of Urogynecology, Japanese Red Cross Gifu Hospital, Gifu 5028511, Japan.
Journal of Clinical Medicine
|June 26, 2025
Summary
Intradetrusor botulinum toxin type A injections significantly improved overactive bladder (OAB) symptoms and reduced detrusor overactivity (DO) in patients unresponsive to other treatments, as confirmed by urodynamic studies.
Area of Science:
- Urology
- Pharmacology
Background:
- Intradetrusor botulinum toxin type A (BoNT-A) injection is a third-line therapy for refractory overactive bladder (OAB) and detrusor overactivity (DO).
- BoNT-A is favored for its extended therapeutic effects.
Purpose of the Study:
- To assess the efficacy of intradetrusor BoNT-A injections in managing refractory OAB using urodynamic studies (UDS).
Main Methods:
- Prospective enrollment of patients from February 2020 to March 2021.
- Standardized UDS performed by a single examiner.
- 100 units of BoNT-A dissolved in saline, injected at 20 sites on the bladder's posterior wall.
Main Results:
- Detrusor overactivity (DO) decreased significantly post-treatment, with 27.3% of patients showing no DO.
- Improvements observed in first sensation of bladder filling, maximum cystometric capacity, and terminal DO.
- Urodynamic studies confirmed significant symptom improvement and reduced OAB symptom scores.
Conclusions:
- Intradetrusor BoNT-A injection offers significant symptom relief for OAB patients refractory to conventional therapies.
- Pre- and post-treatment UDS are valuable tools for demonstrating BoNT-A efficacy.
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