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Open AccessArticle

A Comparative Observational Study to Evaluate the Efficacy of Mid-Urethral Sling with Botulinum Toxin A Injection in Urinary Incontinence Patients

by Yi-Huei Chang 1,2,†, Po-Jen Hsiao 1,2,3,†, Huang Chi-Ping 1,2, Hsi-Chin Wu 1,2,4, Po-Fan Hsieh 1,2,5,* and Eric Chieh-Lung Chou 1,2,4,*
1
Department of Urology, China Medical University Hospital, Taichung 40447, Taiwan
2
School of Medicine, China Medical University, Taichung 40402, Taiwan
3
Department of Urology, China Medical University Hsinchu Hospital, Hsinchu 302056, Taiwan
4
Department of Urology, China Medical University Beigang Hospital, Beigang, Yunlin 651012, Taiwan
5
Graduate Institute of Biomedical Sciences, School of Medicine, China Medical University, Taichung 40402, Taiwan
*
Authors to whom correspondence should be addressed.
Yi-Huei Chang and Po-Jen Hsiao have equally contributed this study.
Toxins 2020, 12(6), 365; https://doi.org/10.3390/toxins12060365
Received: 17 April 2020 / Revised: 28 May 2020 / Accepted: 28 May 2020 / Published: 2 June 2020
This study aimed to evaluate and compare the efficacy and safety of mid-urethral sling (MUS) with botulinum toxin A (BoNT-A) versus MUS only in women with mixed urinary incontinence. This was a comparative observational study, and total of 73 patients were enrolled. A total of 38 and 35 patients received MUS only and MUS with BoNT-A injection, respectively. The efficacy outcome included change in Urinary Incontinence Outcome Scores (UIOS), change in Overactive Bladder Symptom Score (OABSS), and use of antimuscarinic agent or beta-3 agonist. Safety assessments included adverse events including urinary retention, increased postvoid residual volumes, and urinary tract infection. MUS with BoNT-A injection was insignificantly better than MUS only in urinary incontinence outcome (88% vs. 71%, respectively, p = 0.085) at week three. Among the 33 patients with detrusor overactivity (DO), patients who received BoNT-A had a higher cure rate of incontinence (88% vs. 41%, p = 0.01) and less required antimuscarinic agent or beta-3 agonist (31% vs. 94%, p < 0.001) compared to patients who did not receive BoNT-A injection. There was no significant difference in the incidences of adverse events between two groups. BoNT-A injection with MUS demonstrated efficacy and safety in the treatment of mixed urinary incontinence, specifically for women with DO. View Full-Text
Keywords: botulinum toxin A; mid-urethral sling; antimuscarinics; overactive bladder; urinary incontinence botulinum toxin A; mid-urethral sling; antimuscarinics; overactive bladder; urinary incontinence
MDPI and ACS Style

Chang, Y.-H.; Hsiao, P.-J.; Chi-Ping, H.; Wu, H.-C.; Hsieh, P.-F.; Chou, E. .-L. A Comparative Observational Study to Evaluate the Efficacy of Mid-Urethral Sling with Botulinum Toxin A Injection in Urinary Incontinence Patients. Toxins 2020, 12, 365.

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