{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:48:53Z","timestamp":1792612133304,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>Neurogenic lower urinary tract dysfunction (NLUTD) can produce bothersome urinary symptoms, impact quality of life, and in some cases, lead to deterioration of upper urinary tract function. Intradetrusor injection of onabotulinumtoxin\u2010A (BoNT\u2010A) is approved for NLUTD in patients who have an inadequate response to or intolerance of oral pharmacologic therapy (with beta\u20103 agonists and\/or antimuscarinics) for urinary frequency, urgency, urgency incontinence, and\/or impaired compliance. Modifications of its use, including dose, injection location, number of injections, setting of procedure, combination therapy with oral agents, and use among different patient populations have since been explored. Here, we aim to review the literature on BoNT\u2010A in NLUTD with a focus on unique neurologic patient groups as well as patient and technical factors to inform personalized treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a narrative review evaluating the existing literature on BoNT\u2010A in NLUTD, focusing on outcomes across neurologic etiologies, and variation in patient\u2010specific and technical factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across neurologic etiologies, BoNT\u2010A improves quality of life and urodynamic parameters with low rates of adverse effects. Patient factors, including baseline voiding status, ability to self\u2010catheterize, and age are important considerations in treatment selection and initial dosing of BoNT\u2010A. Technical modifications such as reduced injection sites or trigone\u2010including templates have been suggested to reduce adverse effects or improve efficacy but require further study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BoNT\u2010A is an established therapy for NLUTD. Individualized treatment strategies that account for patients\u2019 neurologic etiology and functional status are beneficial in optimizing outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70290","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T07:09:54Z","timestamp":1775632194000},"page":"1500-1506","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How Can We Personalize the Delivery of Onabotulinumtoxin\u2010A for Patients With Neurogenic Lower Urinary Tract Dysfunction?"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3564-4415","authenticated-orcid":false,"given":"Shirley L.","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Urology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William I.","family":"Jaffe","sequence":"additional","affiliation":[{"name":"Division of Urology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9784-2559","authenticated-orcid":false,"given":"Ariana L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Urology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002239"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2005.12.010"},{"key":"e_1_2_8_4_1","unstructured":"BOTOX [Package insert]. Allergan Inc. July 14 2025 https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2024\/103000s5316s5319s5323s5326s5331lbl.pdf."},{"key":"e_1_2_8_5_1","unstructured":"E. M.Sebesta C.Kowalik A. J.Wein andR. 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