Evidence map›Paper›PMID 40423294›Full record

ArticleToxins2025

Intravesical Onabotulinum Toxin A Injection Paradigms for Idiopathic Overactive Bladder: A Scoping Review of Clinical Outcomes, Techniques, and Implications for Practice and Future Research.

Ekene Enemchukwu, Hodan Mohamud, Shada Sinclair, Victoria Harbour, Raveen Syan, Michael Kennelly, Susanna Gunamany

Abstract readScoping Review
In one paragraph

Article in Toxins, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ekene EnemchukwuDepartment of Urology, Stanford School of Medicine, Palo Alto, CA 94304, USA.ORCID 0000-0001-6224-6207
Hodan MohamudTemerty Faculty of Medicine, University of Toronto, Toronto, ON M5S1A1, Canada.
Shada SinclairDepartment of Urology, Stanford School of Medicine, Palo Alto, CA 94304, USA.
Victoria HarbourDepartment of Urology, Stanford School of Medicine, Palo Alto, CA 94304, USA.
Raveen SyanDepartment of Urology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.ORCID 0000-0002-4020-8004
Michael KennellyDepartment of Urology, Atrium Health-Carolinas Medical Center, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA.ORCID 0000-0002-7044-506X
Susanna GunamanyDepartment of Urology, Stanford School of Medicine, Palo Alto, CA 94304, USA.

Funding

Improving Overactive Bladder Treatment Access and Adherence Through Personalized Behavioral Modifications and Mobile Technology-Based InterventionsK23DK131315 · NIDDK · STANFORD UNIVERSITY · PI Ekene Enemchukwu · 2022 to 2026
$971k
NIDDK NIH HHS K23 DK131315
6 · The paper itself

Abstract

INTRODUCTION AND

objectivesOnabotulinum toxin A (BTXA) is an effective treatment for refractory idiopathic overactive bladder (iOAB). Given the wide spectrum of patient factors and combination of symptoms, a tailored approach to management is needed. This scoping review assesses injection paradigms for iOAB. Prior studies have established the safety and efficacy of BTXA injections, and this review focuses on exploring variations in injection techniques that may inform more tailored approaches and support future research toward optimizing patient outcomes.

methodsWe conducted a systematic literature search. Inclusion criteria included full-text English language and primary research studies assessing outcomes in adults undergoing BTXA for iOAB. Findings are summarized using narrative synthesis.

resultsForty-three articles were identified. Key findings include fewer injections (1-10 vs. 20-40) maintains efficacy while reducing procedure time, discomfort, and retreatment hesitancy. Durability appears to be lower with suburothelial and bladder base injections and higher with detrusor and bladder body injections, though these may carry an increased risk of urinary retention requiring clean intermittent catheterization. Trigone inclusion appears safe and effective without increased vesicoureteral reflux risk.

conclusionsStudy heterogeneity and inconsistent reporting limit strong conclusions. Included injection paradigms demonstrated efficacy, high tolerability, symptom relief, and quality-of-life improvements with few adverse events. Further research is needed to refine optimal injection strategies to enhance patient comfort, maximize efficacy, and minimize adverse events. Future studies should ensure comprehensive data collection to clarify these associations.

Indexed as

Botulinum Toxins, Type ANeuromuscular AgentsUrinary Bladder, OveractiveAdministration, IntravesicalHumansTreatment OutcomeUrinary BladderBotulinum Toxins, Type ANeuromuscular Agentsonabotulinum toxin Aidiopathicinjection paradigmonabotulinumtoxinA intravesical injectionoveractive bladdersuburothelialtrigoneurge urinary incontinence

Identifiers

PMID40423294
PMCPMC12115849

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.