Cough-associated detrusor overactivity resolved after intravesical onabotulinumtoxin A injection: A case report

A 68-year-old woman developed urgency urinary incontinence (UUI) one month after tension-free vaginal tape (TVT) surgery for stress urinary incontinence. Pharmacological treatment was ineffective. Pressure-flow study revealed cough-associated detrusor overactivity (CADO). An intravesical injection of 100 U botulinum toxin resolved symptoms and normalized bladder sensation. Six months later, CADO recurred and was successfully treated with a second injection. No adverse events occurred. CADO is often misdiagnosed as stress incontinence, and accurate diagnosis requires urodynamic evaluation. This case highlights the potential of intravesical botulinum toxin for managing CADO, including recurrence. Further studies should establish optimal diagnostic strategies and long-term efficacy.