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

European Urology
Cindy Louise AmundsenPelvic Floor Disorders Network

Abstract

Urgency urinary incontinence (UUI) is a chronic condition for which sacral neuromodulation (SNM) (InterStim/Medtronic) and onabotulinumtoxinA (BTX) (BotoxA/Allergan) are utilized. These therapies have not been compared over extended time. To compare UUI episodes (UUIE) over 24 mo following SNM or BTX. Multicenter, open-label, randomized, extension trial (February 2012-July 2016) at nine US medical centers involving 386 women with ≥6 UUIE over 3 d inadequately managed by medications. Participants were clinical responders to treatment: ≥50% reduction in UUIEs after SNM placement or 1 mo post BTX. SNM (n=194) versus 200 U BTX (n=192). SNM reprogrammings occurred throughout the 24 mo. After 6 mo, two additional BTX injections were allowed. Primary outcome: change in mean daily UUIE over 24 mo. no UUIE, ≥75% and ≥50% UUIE reduction; Overactive Bladder Questionnaire Short Form; Urinary Distress Inventory short form; Incontinence Impact Questionnaire; Patient Global Impression of Improvement; Overactive Bladder Satisfaction of Treatment Questionnaire; and adverse events (AEs). Primary analysis used a linear mixed model. Outcome data were available for 260/298 (87%) clinical responders. No difference in decreased mean UUIE was found ov...Continue Reading

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Citations

Jan 9, 2019·Neurourology and Urodynamics·Devin N PatelJennifer T Anger
Feb 8, 2019·International Urogynecology Journal·Katherine E HuskElizabeth J Geller
May 7, 2020·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Cássio L Z Riccetto
Apr 4, 2019·Archives of Gynecology and Obstetrics·Matthias OelkeChristl Reisenauer
Jan 7, 2020·International Neurourology Journal·Louis-Paul BerthelotJulie Carrouget
Apr 3, 2019·Nature Reviews. Urology·Benjamin AbelsonMargot S Damaser
Oct 13, 2018·Der Urologe. Ausg. A·Arndt van Ophoven
Sep 9, 2018·Current Urology Reports·Rose Leu, Gillian L Stearns
Nov 26, 2020·International Urogynecology Journal·Whitney K Hendrickson, Cindy L Amundsen
Jan 9, 2021·International Urogynecology Journal·Whitney K Hendrickson, Cindy L Amundsen
Nov 22, 2020·International Journal of Clinical Practice·Arun SahaiDudley Robinson
Jan 5, 2021·Current Opinion in Urology·Hatim ThakerMin Dong
Jun 4, 2019·Female Pelvic Medicine & Reconstructive Surgery·Brian J LinderElizabeth B Habermann
Jan 13, 2021·Scientific Reports·James A HokansonWarren M Grill
Feb 17, 2021·The Journal of Obstetrics and Gynaecology Research·Victor W NittiMickey Karram
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Jul 7, 2020·European Urology Focus·Pedro Abreu-MendesFrancisco Cruz

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