Selective Bladder Denervation via Radiofrequency Ablation Versus Intravesical Onabotulinum Toxin A for Refractory Overactive Bladder: The Short-Term Results of A Preliminary Randomized Controlled Trial

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2025-09-24 DOI:10.1111/luts.70032

Salih Zeki Sönmez, İsmail Ulus, Aykut Çolakerol, Mustafa Zafer Temiz, Enes Pay, Muhammet Murat Dinçer

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引用次数: 0

Abstract

Introduction

Overactive bladder (OAB) is a prevalent and burdensome condition associated with significant impairments in health-related quality of life and substantial healthcare costs. While third-line therapies such as intravesical onabotulinum toxin A (BTA) and sacral neuromodulation are established treatment options for refractory cases, selective bladder denervation (SBD) via radiofrequency ablation (RFA) has emerged as a novel minimally invasive alternative. This study aimed to prospectively compare the efficacy and safety of SBD versus BTA in women with refractory OAB.

Methods

In this randomized controlled trial, 54 women with refractory OAB were allocated to receive either SBD or BTA. Patients were followed for 12 weeks and assessed for changes in urgency episodes, urgency urinary incontinence (UUI), daily voiding frequency, overactive bladder symptom scores (OAB-V8), quality of life (I-QOL), post-void residual (PVR) volume, and treatment-emergent adverse events.

Results

Both interventions resulted in significant symptom improvement relative to baseline (p < 0.05). However, BTA demonstrated superior therapeutic efficacy, with a significantly higher proportion of patients achieving ≥ 50% reductions in urgency and UUI episodes across all follow-up visits (p < 0.05). Additionally, BTA yielded greater improvements in symptom scores and quality of life indices. Adverse events were infrequent and mild in both groups. The BTA group exhibited a transient increase in PVR at early follow-up, though no cases of acute urinary retention necessitating catheterization were observed. The SBD group showed modest symptom relief with stable objective parameters.

Conclusion

In this prospective randomized trial, intravesical BTA provided superior clinical efficacy compared to SBD across both subjective and objective outcome measures in women with refractory OAB. While SBD may represent a minimally invasive option for select patient populations, BTA remains the more effective third-line intervention. Further large-scale, sham-controlled studies with longer follow-up are warranted to clarify the role of SBD and optimize patient selection.

Abstract Image

查看原文本刊更多论文

射频消融术与膀胱内肉毒杆菌毒素A治疗难治性过度活跃膀胱的选择性膀胱去神经支配：一项初步随机对照试验的短期结果。

膀胱过动症（OAB）是一种普遍且负担沉重的疾病，与健康相关的生活质量和大量医疗保健费用显著受损有关。虽然膀胱内肉毒杆菌毒素A （BTA）和骶骨神经调节等三线治疗已成为难治性病例的治疗选择，但通过射频消融（RFA）的选择性膀胱去神经支配（SBD）已成为一种新的微创选择。本研究旨在前瞻性比较SBD与BTA治疗难治性OAB的疗效和安全性。方法：在这项随机对照试验中，54名难治性OAB女性被分配接受SBD或BTA治疗。对患者进行为期12周的随访，评估急症发作、急症尿失禁（UUI）、每日排尿频率、膀胱过度活动症状评分（OAB-V8）、生活质量（I-QOL）、排尿后残留（PVR）体积和治疗后出现的不良事件的变化。结果：与基线相比，两种干预措施均显著改善了症状(p)。结论：在这项前瞻性随机试验中，与SBD相比，膀胱内BTA在难治性OAB女性的主观和客观结果测量中均提供了更好的临床疗效。虽然SBD可能是选择患者群体的微创选择，但BTA仍然是更有效的三线干预。进一步的大规模、长时间随访的假对照研究是有必要的，以阐明SBD的作用并优化患者选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.