ReviewNeurourology and urodynamics2026
"What Medical Management Should Be First Line for Bladder Storage Symptoms in NLUTD"-Pro Botox.
Review in Neurourology and urodynamics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
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Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectivesNeurogenic lower urinary tract dysfunction (NLUTD) severely impairs patient quality of life (QoL). While oral medications are often first-line treatments, their high failure rates and side effects limit their effectiveness. Thus, we argue for the use of intravesical botulinum toxin A (BoNT-A) injections as a first-line alternative. MATERIALS AND
methodsA PubMed search identified 81 studies on NLUTD and BoNT-A, 26 of which were analyzed for the efficacy of BoNT-A as a first-line treatment.
resultsBoNT-A significantly improved renal function and urinary continence, as indicated by significant reductions in maximum detrusor pressure and increases in maximum cystometric capacity, respectively. Mechanisms for which BoNT-A treatment also improved urinary urgency were found to include sensory pathway modulation and neurotransmitter inhibition. Finally, QoL was found to significantly improve across multiple criteria, including sexual function such as lubrication and orgasm. Importantly, early initiation of BoNT-A treatment yielded better outcomes, emphasizing its value as a first-line treatment. Although side effects include increased post-void residual (PVR), pain, muscle weakness, and reduced efficacy over time, studies have shown that these effects are manageable with dose adjustments and anesthetics.
conclusionBoNT-A offers substantial therapeutic benefits for NLUTD and demonstrates greater effectiveness when used early; thus, it should be considered a first-line treatment option.
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Registered trials
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.