{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:07:39Z","timestamp":1788782859270,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Overactive bladder (OAB) is characterized by urinary frequency and can be associated with urge urinary incontinence. OAB has a significant impact on quality of life if left untreated. Many patients may find their symptoms are refractory to medication or unable to tolerate medication side effects. Surgical treatments include sacral nerve stimulation (SNS) and intravesical Botulinum toxin injection (BTX). Surgeons may recommend SNS as the preferred treatment to patients with concomitant faecal symptoms who have an increased risk of poor bladder emptying or are unwilling or unable to perform intermittent self\u2010catheterization, however, there is a subgroup of patients who elect to proceed with BTX treatments despite these concerns. We aim to investigate the decision\u2010making process amongst the subset of patients who undergo BTX despite being preferred candidates for SNS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this qualitative study, eligible participants with OAB who opted for Botox treatment despite being considered a preferred candidate for SNS by their treating clinician were invited to participate in a semi\u2010structured interview. Patient understanding of both BTX and SNS options and their perceptions towards each treatment were explored. Data were analyzed using reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten participants were interviewed in this study, with a mean interview length of 29.5\u2009min. Themes identified included: familiarity is reassuring, pre\u2010existing perceptions, and keeping it simple.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Furthering our understanding of patients' concerns regarding treatments for OAB, including BTX and SNS, can help patient\u2010centered counseling, which is essential to delivering high\u2010quality, individualized care. In our study, we found that participants expressed a preference for familiar, as well as simpler, less complex treatments. Participants were influenced by pre\u2010existing perceptions that may not be anticipated by the clinician. Taking time to explore a patients' concerns and understanding can enhance shared decision\u2010making and optimize clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70432","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:09:11Z","timestamp":1788779351000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Why Do Clinically Ideal Sacral Nerve Stimulator Candidates Choose Botulinum Toxin Instead? A Study of Advanced Overactive Bladder Treatment Decision\u2010Making"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1810-5906","authenticated-orcid":false,"given":"Jessica","family":"Wynn","sequence":"first","affiliation":[{"name":"Department of Urology University Hospital Geelong, Barwon Health Geelong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Ying","family":"Zeng","sequence":"additional","affiliation":[{"name":"Deakin University School of Medicine Geelong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7278-1481","authenticated-orcid":false,"given":"Kathryn","family":"McLeod","sequence":"additional","affiliation":[{"name":"Department of Urology University Hospital Geelong, Barwon Health Geelong Australia"},{"name":"Deakin University School of Medicine Geelong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/AOG.0000000000003320","article-title":"A Patient\u2010Centered Approach to Refractory Overactive Bladder and Barriers to Third\u2010Line Therapy","volume":"134","author":"Davenport A.","year":"2019","journal-title":"Obstetrics and Gynecology"},{"issue":"5","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.euf.2018.05.004","article-title":"Management of Idiopathic Overactive Bladder Syndrome: What Is the Optimal Strategy After Failure of Conservative Treatment?","volume":"4","author":"Marcelissen T.","year":"2018","journal-title":"European urology focus"},{"issue":"5","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1097\/JU.0000000000001950","article-title":"Patient Perceptions Impact Progression to Third\u2010Line Therapy for Treatment of Overactive Bladder","volume":"206","author":"Iyer S.","year":"2021","journal-title":"Journal of Urology"},{"issue":"8","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1002\/nau.22876","article-title":"Use of Best\u2010Worst Scaling to Assess Patient Perceptions of Treatments for Refractory Overactive Bladder","volume":"35","author":"Beusterien K.","year":"2016","journal-title":"Neurourology and Urodynamics"},{"issue":"2","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1002\/nau.22797","article-title":"Do We Understand How Botulinum Toxin Works and Have We Optimized the Way it is Administered to the Bladder? ICI\u2010RS 2014: Do We Understand How Botulinum Toxin Works?","volume":"35","author":"Apostolidis A.","year":"2016","journal-title":"Neurourology and Urodynamics"},{"issue":"1","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1002\/nau.25054","article-title":"Are We Underestimating Urinary Retention Following Intravesical Onabotulinumtoxina in Women with Overactive Bladder and a History of Prior Pelvic Surgery?","volume":"42","author":"Holmes A.","year":"2023","journal-title":"Neurourology and Urodynamics"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"S46","DOI":"10.1002\/nau.24055","article-title":"How Can We Better Manage Drug\u2010Resistant OAB\/DO? ICI\u2010RS 2018","volume":"38","author":"Chermansky C.","year":"2019","journal-title":"Neurourology and Urodynamics"},{"issue":"2","key":"e_1_2_11_9_1","first-page":"S216","article-title":"Onabotulinumtoxina for the Treatment of Patients With Overactive Bladder and Urinary Incontinence: Results of a Phase 3, Randomized, Placebo Controlled Trial","volume":"197","author":"Nitti V. W.","year":"2017","journal-title":"Journal of Urology"},{"issue":"8","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1007\/s00192-014-2360-7","article-title":"Women's Perspective: Intra\u2010Detrusor Botox Versus Sacral Neuromodulation for Overactive Bladder Symptoms After Unsuccessful Anticholinergic Treatment","volume":"25","author":"Balchandra P.","year":"2014","journal-title":"International Urogynecology Journal"},{"issue":"5","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1177\/2051415817742565","article-title":"Sacral Nerve Stimulation Versus Intravesical Botulinum Toxin Injections for Medically Refractory Overactive Bladder: A Contemporary Review of UK Treatment from Both Clinician and Patients' Perspectives","volume":"11","author":"Nobrega R.","year":"2018","journal-title":"Journal of Clinical Urology"},{"issue":"10","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1007\/s11255-015-1100-3","article-title":"Patient Preferences for Treating Refractory Overactive Bladder in the UK","volume":"47","author":"Hashim H.","year":"2015","journal-title":"International Urology and Nephrology"},{"key":"e_1_2_11_13_1","volume-title":"Sacral Neuromodulation","author":"Feloney M. P.","year":"2024"},{"issue":"2","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using Thematic Analysis in Psychology","volume":"3","author":"Braun V.","year":"2006","journal-title":"Qualitative research in psychology"},{"issue":"1","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/medu.13124","article-title":"Shedding the Cobra Effect: Problematising Thematic Emergence, Triangulation, Saturation and Member Checking","volume":"51","author":"Varpio L.","year":"2017","journal-title":"Medical Education"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","DOI":"10.1177\/2055207619888073","article-title":"The Role of Internet Resources in Health Decision\u2010Making: A Qualitative Study","volume":"5","author":"Bussey L. G.","year":"2019","journal-title":"Digital Health"},{"issue":"4","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/j.pec.2020.11.016","article-title":"The Influence of Online Health Information on Health Decisions: A Systematic Review","volume":"104","author":"Thapa D. K.","year":"2021","journal-title":"Patient Education and Counseling"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70432","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nau.70432","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70432","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:09:14Z","timestamp":1788779354000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.70432"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":16,"alternative-id":["10.1002\/nau.70432"],"URL":"https:\/\/doi.org\/10.1002\/nau.70432","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]},"assertion":[{"value":"2025-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"nau.70432"}}