{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T07:33:46Z","timestamp":1785569626187,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,5,24]],"date-time":"2018-05-24T00:00:00Z","timestamp":1527120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Urethral sphincter hyperactivity resulting in voiding dysfunction is frequently encountered. Medical treatment might not achieve a satisfactory result. OnabotlinumtoxinA urethral sphincter injection relaxes sphincter tonicity and possibly resumes efficient voiding. This study analyzed the treatment outcomes and predictor for successful onabotulinumtoxinA treatment on these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with voiding dysfunction due to urethral sphincter hyperactivity and treated with injections of 100\u2009U onabotulinumtoxinA into the urethral sphincter were retrospectively reviewed. Treatment outcomes were assessed 1 month after injection using the Global Response Assessment and were analyzed by demographic and baseline video\u2010urodynamic characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 95 patients included, satisfactory outcomes were reported in 58 (61.1%) patients. Treatment outcome was not related to age, gender, or voiding dysfunction subtype. Patients with satisfactory outcomes had a significantly smaller volume at first sensation of filling (<jats:italic>P<\/jats:italic>\u2009=\u20090.046), greater detrusor pressure (<jats:italic>P<\/jats:italic>\u2009=\u20090.027), higher maximum flow rate (<jats:italic>P<\/jats:italic>\u2009=\u20090.017), and smaller post\u2010void residual (<jats:italic>P<\/jats:italic>\u2009=\u20090.006). In multivariate analysis, an open bladder neck during voiding was the only predictor for successful outcome (88% in satisfactory outcome, 12% in failure outcome, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Patients with non\u2010neurogenic voiding dysfunction had a significantly longer therapeutic duration than those with neurogenic voiding dysfunction (9.55\u2009\u00b1\u20094.18 vs 7.44\u2009\u00b1\u20092.91 months, <jats:italic>P<\/jats:italic>\u2009=\u20090.033). Increased urinary incontinence was reported in 18 patients, including 6 with stress urinary incontinence and 12 with urgency urinary incontinence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Subjective improvement was reported in 61.1% of patients with voiding dysfunction due to urethral sphincter hyperactivity after onabotulinumtoxinA urethral sphincter injection. An open bladder neck during voiding at baseline predicts a successful outcome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.23714","type":"journal-article","created":{"date-parts":[[2018,5,24]],"date-time":"2018-05-24T07:36:30Z","timestamp":1527147390000},"page":"2651-2657","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Therapeutic effect of urethral sphincter onabotulinumtoxinA injection for urethral sphincter hyperactivity"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7870-1574","authenticated-orcid":false,"given":"Yuan\u2010Hong","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Urology Buddhist Tzu Chi General Hospital and Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng\u2010Fu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology Buddhist Tzu Chi General Hospital and Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Fong","family":"Jhang","sequence":"additional","affiliation":[{"name":"Department of Urology Buddhist Tzu Chi General Hospital and Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7165-4771","authenticated-orcid":false,"given":"Hann\u2010Chorng","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Urology Buddhist Tzu Chi General Hospital and Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,24]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"127","article-title":"Detrusor sphincter dyssynergia: a review of physiology, diagnosis, and treatment strategies","volume":"5","author":"Stoffel JT","year":"2016","journal-title":"Transl Androl 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