Efficacy and safety of botulinum toxin type A injection combined with sacral neuro-modulation in the treatment of idiopathic non-obstructive urinary retention
10.3969/j.issn.1009-8291.2025.12.009
- VernacularTitle:A型肉毒毒素注射联合骶神经调控术治疗特发性非梗阻性尿潴留的疗效与安全性
- Author:
Yongkun ZENG
1
;
Qingwei WANG
1
;
Wen ZHU
1
;
Zikai LI
1
;
Shuo XU
1
;
Chuanyu WANG
1
;
Ke JIN
1
Author Information
1. Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
- Publication Type:Journal Article
- Keywords:
dysuria;
urinary control;
idiopathic non-obstructive urinary retention;
botulinum toxin A;
sacral neuromodulation
- From:
Journal of Modern Urology
2025;30(12):1069-1074
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of botulinum toxin A (BTX-A) injection into the external urethral sphincter in combination with sacral neuromodulation (SNM) for the treatment of idiopathic non-obstructive urinary retention (INOUR). Methods A total of 57 INOUR patients treated in our hospital during May 2022 and May 2024 were enrolled. Patients were divided into the BTX (n=30) and combined groups (n=27) according to whether they chose SNM after BTX-A injection. The baseline, postoperative 1-month and 6-month consecutive 3-day voiding diaries, quality of life score (QoL), and post-void residual (PVR), preoperative and postoperative 1-month urodynamic results, and postoperative complications were recorded and compared between the two groups. Results One month after surgery, the average number of voiding frequency per day and PVR were lower in both groups than those before surgery (P<0.05), while the average daily urine volume and maximum flow rate (MFR) were higher (P<0.05). There was no statistically significant difference between the maximum detrusor pressure during micturition in both groups before and after surgery (P>0.05). One month after surgery, the average number of voiding frequency per day, average daily urine volume, PVR, QoL, MFR, bladder compliance (BC), and maximum cystometric capacity (MCC) were better in the combined group than in the BTX group (P<0.05), and the efficiency was higher in the combined group (88.9% vs.63.3%, P<0.05). Six months after surgery, the efficacy of the BTX group returned to the baseline level with no statistically significant difference, whereas the efficacy of the combined group was stable (not different from the postoperative 1-month indicators, but better than the baseline level). During the follow-up, there was no difference in the incidence of complications between the BTX group and combined group [43.3% (13/30) vs. 48.1% (13/27), P>0.05]. Conclusion BTX-A injection into the external urethral sphincter combined with SNM improves the short-term outcomes of INOUR patients and maintains the efficacy 6 months postoperatively, which is a safe and reliable treatment option.
