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Volume 14
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10.3390/jcm14124151
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

The Efficacy of Intradetrusor Onabotulinumtoxin A Injection for Refractory Overactive Bladder Syndrome—A Single-Center Prospective Study

by
Chie Nakai
1,
Kosei Miwa
1,
Yasuhide Kitagawa
2,
Moemi Kikuchi
1,
Sanae Namiki
1,
Mina Kikuchi
1,3,
Kota Kawase
4,
Koji Iinuma
4,
Yuki Tobisawa
4,
Keita Nakane
4 and
Takuya Koie
4,*
1
Department of Urogynecology, Japanese Red Cross Gifu Hospital, Gifu 5028511, Japan
2
Department of Urology, Komatsu Municipal Hospital, Komatsu 9238560, Japan
3
Department of Urogynecology, Sugo Clinic, Gifu 5020914, Japan
4
Department of Urology, Gifu University, Graduate School of Medicine, Gifu 5011194, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(12), 4151; https://doi.org/10.3390/jcm14124151
Submission received: 10 April 2025 / Revised: 29 May 2025 / Accepted: 9 June 2025 / Published: 11 June 2025
(This article belongs to the Section Nephrology & Urology)
Versions Notes

Abstract

Background/Objectives: Intradetrusor botulinum toxin injection is a well-established third-line therapy for patients with refractory overactive bladder (OAB) and detrusor overactivity (DO). Botulinum toxin type A (BoNT-A) is most commonly used due to its prolonged therapeutic duration. We aimed to evaluate the effectiveness of intradetrusor BoNT-A injection therapy in managing refractory OAB by performing a urodynamic study (UDS). Methods: The patients were prospectively enrolled between February 2020 and March 2021. The patients received treatment regimens comprising behavioral modification therapy, pelvic floor muscle physiotherapy, and/or OAB medications for at least three months. The UDS procedure was carried out by a single examiner, in accordance with the International Continence Society standards for good urodynamic practice. A total of 100 units of BoNT-A was dissolved in 10 mL of saline, and 0.5 mL (5 units) was injected at 20 sites on the posterior wall of the bladder. The primary endpoint was the change in DO, which was measured using the UDS from the baseline to two months after treatment with BoNT-A. Results: Prior to treatment initiation, DO was observed in all the patients during the UDS. The occurrence of DO during the filling phase demonstrated a significant decrease following treatment, with DO no longer identified in 27.3% of the patients. The first sensation of bladder filling, maximum cystometric capacity, DO, and terminal DO all demonstrated significant improvement after intradetrusor BoNT-A injection, based on the UDS. The OAB symptom scores also significantly decreased after BoNT-A therapy. Conclusions: The present study demonstrated that intradetrusor BoNT-A injection significantly improved symptoms in patients with OAB who had been unresponsive to various treatments. This study also demonstrated the usefulness of performing a UDS before and after treatment to prove the efficacy of BoNT-A.
Keywords: cough-associated detrusor overactivity; urgency urinary incontinence; refractory overactive bladder; intradetrusor onabotulinumtoxin A injection therapy cough-associated detrusor overactivity; urgency urinary incontinence; refractory overactive bladder; intradetrusor onabotulinumtoxin A injection therapy

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MDPI and ACS Style

Nakai, C.; Miwa, K.; Kitagawa, Y.; Kikuchi, M.; Namiki, S.; Kikuchi, M.; Kawase, K.; Iinuma, K.; Tobisawa, Y.; Nakane, K.; et al. The Efficacy of Intradetrusor Onabotulinumtoxin A Injection for Refractory Overactive Bladder Syndrome—A Single-Center Prospective Study. J. Clin. Med. 2025, 14, 4151. https://doi.org/10.3390/jcm14124151

AMA Style

Nakai C, Miwa K, Kitagawa Y, Kikuchi M, Namiki S, Kikuchi M, Kawase K, Iinuma K, Tobisawa Y, Nakane K, et al. The Efficacy of Intradetrusor Onabotulinumtoxin A Injection for Refractory Overactive Bladder Syndrome—A Single-Center Prospective Study. Journal of Clinical Medicine. 2025; 14(12):4151. https://doi.org/10.3390/jcm14124151

Chicago/Turabian Style

Nakai, Chie, Kosei Miwa, Yasuhide Kitagawa, Moemi Kikuchi, Sanae Namiki, Mina Kikuchi, Kota Kawase, Koji Iinuma, Yuki Tobisawa, Keita Nakane, and et al. 2025. "The Efficacy of Intradetrusor Onabotulinumtoxin A Injection for Refractory Overactive Bladder Syndrome—A Single-Center Prospective Study" Journal of Clinical Medicine 14, no. 12: 4151. https://doi.org/10.3390/jcm14124151

APA Style

Nakai, C., Miwa, K., Kitagawa, Y., Kikuchi, M., Namiki, S., Kikuchi, M., Kawase, K., Iinuma, K., Tobisawa, Y., Nakane, K., & Koie, T. (2025). The Efficacy of Intradetrusor Onabotulinumtoxin A Injection for Refractory Overactive Bladder Syndrome—A Single-Center Prospective Study. Journal of Clinical Medicine, 14(12), 4151. https://doi.org/10.3390/jcm14124151

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