{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:48:34Z","timestamp":1788364114528,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T00:00:00Z","timestamp":1705276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>The negative impact on quality of life and the economic\u2010related burden to the patient and the health care system associated with idiopathic overactive bladder (iOAB) is well\u2010documented. Intradetrusor OnabotulinumtoxinA (BTN\/A) injections are a well\u2010used treatment modality for the management of overactive detrusor refractory to medical management, with well\u2010documented efficacy and safety profiles. There is currently no best practice guideline for the administration of BTN\/A for this procedure and historically the trigone of the bladder has been excluded from the injection paradigm given the risk of vesicoureteral reflux (VUR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A scoping review methodology was employed to assess available literature to evaluate current techniques used. There is emerging literature that the inclusion of the trigone may increase the efficacy of the procedure, while maintaining a similar adverse effect profile. Similar results could also be obtained by decreasing the number of injection sites. A scoping review was completed with systematic methodology using the Preferred Systematic Reviews and Meta Analyses extension for Scoping Review checklist. The search strategy looked to evaluate BTN\/A and number of injection sites and the inclusion of the trigone in female patients with iOAB. Studies with male or neurogenic bladder only were excluded. Mixed studies were included. A specialist research librarian was engaged, with supervision from a functional urologist using a combination of MeSH and natural language terms. Two investigators independently reviewed the titles and abstracts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve articles were included and were published between 2005 and 2021. There was no evidence of VUR in any of the results. All but one study reported similar if not improved efficacy of trigone\u2010inclusion. Lower number of injection sites had similar efficacy profiles to higher numbers of intradetrusor injections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Further high\u2010quality randomized control trials of trigone inclusion and reduction of injection sites are required. It is hoped that with further exploration of intraoperative methods for BTN\/A injections, the development of universally accepted guidelines may optimize management and experiences for patients with iOAB.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25392","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T05:06:22Z","timestamp":1705381582000},"page":"553-564","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Anatomical location and number of injection sites of intravesical OnabotulinumtoxinA for females with refractory idiopathic overactive bladder: A\u00a0scoping review"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7592-9410","authenticated-orcid":false,"given":"Ellen","family":"Kelsey","sequence":"first","affiliation":[{"name":"Department of Urological Surgery, Barwon Health University Hospital Geelong Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1810-5906","authenticated-orcid":false,"given":"Jessica","family":"Wynn","sequence":"additional","affiliation":[{"name":"Department of Urological Surgery, Barwon Health University Hospital Geelong Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3820-483X","authenticated-orcid":false,"given":"Angela","family":"Holmes","sequence":"additional","affiliation":[{"name":"Department of Urological Surgery, Barwon Health University Hospital Geelong Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"McLeod","sequence":"additional","affiliation":[{"name":"Department of Urological Surgery, Barwon Health University Hospital Geelong Geelong Victoria Australia"},{"name":"Department of Surgery Deakin University Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20870"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins12020129"},{"key":"e_1_2_11_4_1","volume-title":"EAU Guidelines on Urinary Incontinence in Adults","author":"Burkhard F","year":"2018"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2023.05.014"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13246"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2499-2"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000309"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-017-2121-6"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.651635"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.21054"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.10.043"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/luts.12321"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2006.10.047"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.22780"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2005.19.880"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2019.12.001"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-021-02802-0"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23052"},{"issue":"2","key":"e_1_2_11_20_1","first-page":"165","article-title":"Botulinum toxin: historical perspective and treatment of neurogenic and idiopathic overactive bladder","volume":"6","author":"Mulligan D","year":"2009","journal-title":"Clin\u00a0Prac"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","unstructured":"The National Institute for Health and Care Excellence (NICE). The NICE Guidelines: urinary incontinence and pelvic organ prolapse in women: management. April 2 2019. 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Evaluation of an alternative injection paradigm for onabotulinumtoxinA (BOTOX\u00ae) in the treatment of overactive bladder in patients with urinary incontinence (LO\u2010BOT). 2019. 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