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Updated: May 6, 2026

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Urinary Cytokines in Predicting Intradetrusor Onabotulinumtoxin-A Response.

Marina Guirguis Hanna1,2, Ashti M Shah3, Wuqi Li4

  • 1Department of Obstetrics & Gynecology, Division of Urogynecology, Inova Health System, Falls Church, Virginia, USA.

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Summary

Asymptomatic bacteriuria does not impact overactive bladder treatment response with Onabotulinumtoxin-A. Older age and specific urinary inflammatory markers influenced treatment outcomes in women.

Keywords:
Onabotulinumtoxin‐Aasymptomatic bacteriuriabiomarkerscytokinesinflammation

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Area of Science:

  • Urology
  • Immunology
  • Gerontology

Background:

  • Overactive bladder (OAB) affects millions, with Onabotulinumtoxin-A (Botox) as a key treatment.
  • The influence of asymptomatic bacteriuria and urinary inflammation on Botox efficacy remains unclear.
  • Understanding these factors could optimize OAB management.

Purpose of the Study:

  • To investigate the relationship between asymptomatic bacteriuria, urinary inflammatory markers, and response to Onabotulinumtoxin-A in women with refractory OAB.
  • To compare baseline differences in these markers between treatment responders and non-responders.

Main Methods:

  • 75 women with refractory OAB undergoing Onabotulinumtoxin-A injections provided urine samples.
  • Assessed for asymptomatic bacteriuria and quantified 12 urinary cytokines/chemokines.
  • Responders were defined by >11 improvement on the Urinary Distress Inventory Short Form.

Main Results:

  • 60% of participants responded to Onabotulinumtoxin-A.
  • No significant difference in asymptomatic bacteriuria rates between responders and non-responders.
  • Older age was associated with lower response rates; inflammatory markers showed age-dependent effects on response.

Conclusions:

  • Asymptomatic bacteriuria does not appear to affect Onabotulinumtoxin-A efficacy for OAB.
  • Age is a significant factor in treatment response, with older women less likely to benefit.
  • Urinary inflammatory profiles, particularly MCP1 and IP10, interact with age to influence treatment outcomes.