Women’s perspective: intra-detrusor botox versus sacral neuromodulation for overactive bladder symptoms after unsuccessful anticholinergic treatment

Abstract

The botox group seemed more likely to need quicker results with easy access to the treatment modality, whilst the SNM group seemed keener to focus on a more permanent option with a known interval for the repeat procedure. The difference in patient choice was found to be statistically significant.

Can we create a valid treatment algorithm for patients with drug resistant overactive bladder (OAB) syndrome or detrusor overactivity (DO)? Results from a think tank (ICI‐RS 2015)

“…In a study of women with refractory OAB, 74% would choose Botox® over SNM. In the Botox® group, their decision was influenced by their dislike of the thought of having a foreign body in their back (54%), shorter waiting times (46%), and faster onset of effect for Botox® (43%), while in the SNM group the need for repeat Botox® injections at variable intervals (61.5%) and the risk of urinary retention with Botox® (46%) were the main reasons which pushed them toward SNM . These results were quite different from other studies where only 9‐50% of predominantly female ΟΑΒ patients, having used AMs, would choose Βotox® when considering efficacy, method of delivery and possible adverse events .…”

Urinary retention in female OAB after intravesical Botox injection: who is really at risk?

“…However, in another similar study, 74 % of women with OAB chose Botox treatment and 26 % chose SNM after failed anticholinergic treatment. Over 46 % of patients in the SNM group chose SNM to avoid the risk of urinary retention after Botox injections [14]. …”

Adolescence transitional care in neurogenic detrusor overactivity and the use of OnabotulinumtoxinA: A clinical algorithm from an Italian consensus statement

“…Moreover, the use of onaBNTa is less invasive than sacral neuromodulation (SNM) or bladder augmentation. Patients preferred botulinum toxin over the SNM as has been reported in several studies . A standardized protocol to manage a specific pathological condition allows clinicians to better identify those subjects who do not respond to first line treatment and lets them to choose an alternative therapeutic option when necessary.…”

“…Patients preferred botulinum toxin over the SNM as has been reported in several studies. [56][57][58] A standardized protocol to manage a specific pathological condition allows clinicians to better identify those subjects who do not respond to first line treatment and lets them to choose an alternative therapeutic option when necessary. As a further support of this concept, some of our panelists recently published a national consensus statement on real life clinical practice of onaBNTa intravesical injections for wet overactive bladder.…”