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Endoscopic Topical Application (ETA) Therapy for Refractory Overactive Bladder: A First-in-Human Report
Takuya Sadahira1,2, Masahiro Sugihara3, Yosuke Mitsui1,4
1Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN.
Cureus
|February 10, 2026
Summary
Refractory overactive bladder (OAB) is challenging to treat. Endoscopic topical application (ETA) of botulinum toxin (BTX) to the bladder trigone offers a promising sensory-focused approach for patients with OAB.
Area of Science:
- Urology
- Neuroscience
- Pharmacology
Background:
- Refractory overactive bladder (OAB) presents a significant clinical challenge, with existing treatments like anticholinergics, β3-agonists, and intradetrusor botulinum toxin (BTX) offering limited efficacy for some patients.
- Emerging research highlights the role of bladder sensory mechanisms, particularly in the trigone, in contributing to persistent urinary urgency and frequency.
- Current intradetrusor BTX injections may not effectively target these superficial sensory pathways due to drug distribution primarily within the detrusor muscle.
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