{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:54:33Z","timestamp":1791438873831,"version":"4.3.3"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"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>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study in consecutive patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the long\u2010term effectiveness of and treatment adherence to intradetrusor onabotulinumtoxin A (BoNT\u2010ONA) injections in patients with neurogenic detrusor overactivity (NDO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Consecutive patients with NDO who had undergone intradetrusor BoNT\u2010ONA treatment at a single tertiary neuro\u2010urology referral center were identified from a registry documenting off\u2010label use of BoNT\u2010ONA prior to formal regulatory approval. Demographic, clinical, and urodynamic data obtained before and after each treatment were collected. In patients performing intermittent catheterization, treatment success was defined by the following urodynamic criteria: bladder capacity \u2265\u2009400\u2009mL, bladder compliance \u226520\u2009mL\/cmH\n                      <jats:sub>2<\/jats:sub>\n                      O, and maximum detrusor storage pressure &lt;40\u2009cmH\n                      <jats:sub>2<\/jats:sub>\n                      O. In patients with an indwelling catheter, treatment success was defined as the achievement of urinary continence. In addition, data regarding treatment discontinuation and the underlying reasons were collected. Descriptive statistical analyses were performed to evaluate treatment effectiveness, adherence, and discontinuation patterns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The data of 142 patients (51 females) with a mean age of 35.9\u2009\u00b1\u200913.1 years and a mean NDO duration of 6.4\u2009\u00b1\u20098.1 years at the beginning of the BoNT\u2010ONA treatment were analyzed. Over a mean follow\u2010up period of 12.0\u2009\u00b1\u20096.1 years, evaluated patients received a mean 7.9\u2009\u00b1\u20095.5 treatments. The BoNT\u2010ONA treatment was continued in 34 (23.9%) patients. In 95 (66.9%) patients, the treatment was discontinued, and 13 (9.2%) patients were lost to follow\u2010up. Five of the 34 patients (14.7%) who continued BoNT\u2010ONA treatment received additional oral medication for NDO. Two (5.9%) and three (8.8%) patients showed reduced bladder compliance and increased detrusor storage pressure, respectively. Ten (34.5%) patients showed increased cystatin C values during the follow\u2010up. The main reason for BoNT\u2010ONA treatment discontinuation was insufficient effectiveness in 56 (58.9%) patients. Most patients who discontinued treatment transitioned to oral medication (45\/95, 47.4%) and surgical interventions (25\/95, 26.3%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Treatment of NDO with BoNT\u2010ONA injections into the detrusor demonstrated sustained effectiveness in one quarter of the evaluated patients during a follow\u2010up period of more than 12 years. The main reason for BoNT\u2010ONA treatment discontinuation was insufficient effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70469","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:32:31Z","timestamp":1791437551000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Clinical Effectiveness of and Adherence to Onabotulinumtoxin A Injections for Neurogenic Detrusor Overactivity"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2853-6280","authenticated-orcid":false,"given":"Julia","family":"Neuenschwander","sequence":"first","affiliation":[{"name":"Neuro\u2010Urology, Swiss Paraplegic Centre Nottwil Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9910-1295","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Pannek","sequence":"additional","affiliation":[{"name":"Neuro\u2010Urology, Swiss Paraplegic Centre Nottwil Switzerland"},{"name":"Neuro\u2010Urology, Swiss Paraplegic Research Nottwil Switzerland"},{"name":"Department of Urology Inselspital, Bern University Hospital, University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2518-8738","authenticated-orcid":false,"given":"Jens","family":"W\u00f6llner","sequence":"additional","affiliation":[{"name":"Neuro\u2010Urology, Swiss Paraplegic Centre Nottwil Switzerland"},{"name":"Neuro\u2010Urology, Swiss Paraplegic Research Nottwil Switzerland"},{"name":"Medicine and Medical Sciences, Health Sciences and Medicine, University of Lucerne Lucerne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1807-2670","authenticated-orcid":false,"given":"J\u00f6rg","family":"Krebs","sequence":"additional","affiliation":[{"name":"Neuro\u2010Urology, Swiss Paraplegic Centre Nottwil Switzerland"},{"name":"Medicine and Medical Sciences, Health Sciences and Medicine, University of Lucerne Lucerne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.eururo.2024.03.026","article-title":"Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology","volume":"85","author":"Sartori A. 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