{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T17:40:29Z","timestamp":1738172429085,"version":"3.34.0"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T00:00:00Z","timestamp":1714608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Sacral neuromodulation (SNM) and onabotulinumtoxinA (BoNTA) injection are third\u2010line therapies for overactive bladder (OAB). Although the efficacy of each third\u2010line treatment has been well established in clinical trials, there is far less information about performing one third\u2010line therapy after the other. Our aim is thus to investigate the outcomes of post\u2010SNM BoNTA and post\u2010BoNTA SNM as \u201csecond\u201d third\u2010line treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed all OAB patients who had both SNM and BoNTA between 2013 and 2022. The primary endpoint was the response rates (&gt;50% improvements) of the second third\u2010line treatments. Secondary endpoints were the proportion of the patients who achieved total dry, the duration of treatments of patients who had significant responses, and risk factors that are associated with treatment response or duration of treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 172 patients had two third\u2010line therapies. There were 104 patients who had post\u2010SNM BoNTA and 68 patients who had post\u2010BoNTA SNM. In the post\u2010SNM BoNTA group, 62.5% (65\/104) had significant responses after BoNTA treatment. In the post\u2010BoNTA SNM group, 61.8% (44\/68) had significant responses after SNM treatment. The proportions of patients who became dry were 21.2% and 23.5%, respectively. In the post\u2010SNM BoNTA group, spinal pathology is associated with a lower probability of a significant response (48.9% vs. 73.7%, <jats:italic>p<\/jats:italic>\u2010value\u2009=\u20090.0105).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BoNTA or SNM remains a viable option for refractory OAB after patients fail from one another. Spinal pathology is associated with a poorer response of post\u2010SNM BoNTA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.15463","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T07:29:15Z","timestamp":1714634955000},"page":"772-777","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of sequential third\u2010line therapies in patients with refractory overactive bladder"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3183-1830","authenticated-orcid":false,"given":"Po\u2010Ming","family":"Chow","sequence":"first","affiliation":[{"name":"Glickman Urological Institute Cleveland Clinic  Cleveland Ohio USA"},{"name":"National Taiwan University Hospital and College of Medicine  Taipei Taiwan"},{"name":"National Taiwan University Hospital Hsin\u2010Chu Branch  Zhubei City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler","family":"Trump","sequence":"additional","affiliation":[{"name":"Glickman Urological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard B.","family":"Goldman","sequence":"additional","affiliation":[{"name":"Glickman Urological Institute Cleveland Clinic  Cleveland Ohio 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