Two-Year Outcomes of Sacral Neuromodulation Versus OnabotulinumtoxinA for Refractory Urgency Urinary Incontinence: A Randomized Trial

Conclusions Both treatments offered sustainable UUI improvement, and higher BTX dosing had low clean intermittent catheterization rates, but with UTI risk. SNM revision/removal rates were low due to standardized lead placement with strict treatment response definitions. Patient summary We compared a large group of US women with severe urgency urinary incontinence (UUI) who received sacral neuromodulation (InterStim) or onabotulinumtoxinA (Botox A) therapy during a 2-yr period. We found that both therapies had similar success in reducing UUI symptoms, and adverse events were low. However, women in the BotoxA group had higher satisfaction and endorsement with their treatment, but with a higher chance of a urinary tract infection. We conclude that both therapies offer sustained reduction in daily incontinence over 2 yr. Sacral neuromodulation and 200 U onabotulinumtoxinA resulted in similar sustained improvements in urgency urinary incontinence episodes throughout 24 mo. OnabotulinumtoxinA provided higher treatment satisfaction and endorsement, and greater treatment preference. Adverse events were low; however, urinary tract infection rates were higher following onbotulinumtoxinA.
Source: European Urology - Category: Urology & Nephrology Source Type: research