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International Urogynecology Journal

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01-03-2021 | Overactive Bladder | Review Article

Treatment for refractory overactive bladder: a systematic review and meta-analysis of sacral neuromodulation and onabotulinumtoxinA

Authors: Qing He, Boya Li, Chi Zhang, Jie Zhang, Deyi Luo, Kunjie Wang

Published in: International Urogynecology Journal | Issue 3/2021

Abstract

Introduction and hypothesis

This systematic review and meta-analysis aim to evaluate the outcomes between SNM and BTX in the treatment of refractory OAB.

Methods

PubMed, Embase, and CENTRAL were comprehensively searched from their inception to December 2019. Randomized and nonrandomized controlled trials evaluating OAB patients who underwent SNM and BTX were included. Data extraction and quality assessment were conducted by two independent reviewers. The outcomes, side effects, and cost-effectiveness values of both procedures were compared in meta-analysis.

Results

This review involved six articles (2629 patients). Specifically, three articles were based on the same trial, and the other studies were retrospective cohort studies. No significant difference was found in successful treatment between BTX and SNM at 6 months after procedures [risk ratio (RR) = 0.93, 95% confidence interval (CI) 0.63–1.39]. BTX exhibited a significantly higher total adverse event rate than SNM through 6 months (RR = 1.55, 95% CI 1.28–1.88). Patients suffered more urinary tract infection (UTI) risk under BTX injection at the early stage (RR = 1.58, 95% CI 1.10–2.25); however, the difference in UTI events was not significant between the two groups (RR = 1.13, 95% CI 1.10–2.25) during the period of 7–12 months postoperatively. Obviously, the short-term cost (1–2 years) of BTX was significantly lower than that of the SNM procedure.

Conclusions

Both treatments were effective; however, because of the high complication rate of BTX, it may not be a better way to treat refractory OAB than SNM, although BTX is more cost-effective for short-term treatment at present.

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Title: Treatment for refractory overactive bladder: a systematic review and meta-analysis of sacral neuromodulation and onabotulinumtoxinA
Authors: Qing He
Boya Li
Chi Zhang
Jie Zhang
Deyi Luo
Kunjie Wang
Publication date: 01-03-2021
Publisher: Springer International Publishing
Keywords: Overactive Bladder
Nerve Stimulation
Urinary Tract Infection
Published in: International Urogynecology Journal / Issue 3/2021
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-020-04427-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Treatment for refractory overactive bladder: a systematic review and meta-analysis of sacral neuromodulation and onabotulinumtoxinA

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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