{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T01:04:59Z","timestamp":1759971899484,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aims to explore the impact of age on long\u2010term outcomes associated with intradetrusor botulinum toxin (BoNT) usage (up to four cycles) in elderly patients with refractory overactive bladder syndrome (OAB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We conducted a retrospective observational cohort study across institutions in Nottingham (UK) and Melbourne (Australia). Patients with refractory OAB and treated with intradetrusor BoNT between January 2005 and January 2020 were stratified into age groups: \u226440, 40\u201349, 50\u201359, 60\u201369 and \u226570\u2009years. Efficacy was defined as patient self\u2010reported improvement in symptoms post\u2010BoNT injection. Duration of effect was time (months) between BoNT injection to patient reported onset of symptom recurrence. Data on BoNT type and dosing, urinary tract infection (UTI), urinary retention, ICIQ\u2010OAB and International Consultation on Incontinence Questionnaire Urinary Incontinence (ICIQ\u2010UI) questionnaires were also collected. Statistical analyses were conducted with SPSS\u00ae 25 software. <jats:italic>P<\/jats:italic>\u2010value\u2009&lt;\u20090.05 was considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 943 patients stratified into age groups: &lt; 40 (183), 40\u201349 (150), 50\u201359 (173), 60\u201369 (219) and \u2265 70 (218). Median age was 58 (IQR 44\u201369). Most patients were female 724\/943 (76.8%). From Cycles 1 to 4, age group \u2265 70 efficacy rates were 85.1%, 84.1%, 92.6% and 89.3%. Corresponding median duration of effect (months) were 6.8, 8.0, 7.0 and 8.0. For Cycle 2; age \u2265 70 was a predictor of reduced efficacy (<jats:italic>P<\/jats:italic>\u2009=\u20090.004). Neurogenic causes of OAB were predictors of increased efficacy for Cycles 2 (<jats:italic>P<\/jats:italic>\u2009=\u20090.004) and 3 (<jats:italic>P<\/jats:italic>\u2009=\u20090.0145). Men had higher rates of urinary retention than women in Cycles 1 (42.4% vs 29.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.003) and 2 (37.9% vs 23.0%, <jats:italic>P<\/jats:italic>\u2009=\u20090.0018). All age groups showed improvement in patient\u2010reported outcome measures (PROMs) post\u2010BoNT injection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In elderly patients with refractory OAB and treated with intradetrusor BoNT (up to four cycles), age \u2265\u200970 was an independent predictor for reduced BoNT efficacy (84.1%) in Cycle 2.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bco2.70048","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T01:49:39Z","timestamp":1750816179000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The use of intradetrusor botulinum toxin in the geriatric population"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2471-4126","authenticated-orcid":false,"given":"William","family":"Chui","sequence":"first","affiliation":[{"name":"Department of Urology, Western Health University of 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