{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:42:17Z","timestamp":1747186937710,"version":"3.40.5"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T00:00:00Z","timestamp":1592265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["LUTS"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Two female patients aged 70 and 72 with video\u2010urodynamics\u2010confirmed detrusor overactivity and detrusor underactivity (DO\u2010DU) were treated. Patients were refractory to medical therapies and had previously failed intravesical botulinum toxin type A (BoNT\u2010A) at other centers secondary to urinary retention and difficulty with self\u2010catheterization. Placement of an Interstim II device (Medtronic, Minneapolis, Minnesota) for sacral neuromodulation (SNM) as alternative third\u2010line treatment partially improved overactive bladder (OAB) symptoms while significantly improving voiding symptoms. Postvoid residual (PVR) of patients improved from a median of 118\u2009mL (110\u2010125\u2009mL) to 20\u2009mL (18\u201026\u2009mL) and 213\u2009mL (195\u2010230\u2009mL) to 70\u2009mL (60\u201073\u2009mL), respectively. Addition of medical therapies post SNM failed to modify OAB symptoms further and a rechallenge with dose\u2010reduced BoNT\u2010A was undertaken.OAB symptoms were significantly improved by addition of BoNT\u2010A, while urinary retention was avoided (median PVR post BoNT\u2010A 38 mL [34\u201040\u2009mL] and 185 mL [150\u2010205\u2009mL], respectively). Reduction in incontinence pad use as well as resolution of nighttime incontinence in both patients and daytime incontinence in one patient was achieved. DO\u2010DU patients treated by SNM who have improved bladder emptying (PVR &lt;100\u2009mL) but incomplete resolution of OAB symptoms should be trialed on adjunct medical therapies to improve OAB symptoms. If OAB symptoms are still inadequately controlled, consideration of a rechallenge with BoNT\u2010A, particularly with dose reduction, appears to be efficacious and avoids symptomatic retention in this challenging cohort.<\/jats:p><\/jats:sec>","DOI":"10.1111\/luts.12332","type":"journal-article","created":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T05:22:45Z","timestamp":1592371365000},"page":"194-197","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Botox rechallenge\u2014An additional tool in the management of an incompletely emptying bladder and inadequate overactive symptom control following sacral neuromodulation"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6195-3364","authenticated-orcid":false,"given":"Brennan","family":"Timm","sequence":"first","affiliation":[{"name":"Department of Urology Austin Health  Heidelberg Victoria Australia"},{"name":"North Eastern Urology  Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jyotsna","family":"Jayarajan","sequence":"additional","affiliation":[{"name":"Department of Urology Austin Health  Heidelberg Victoria Australia"},{"name":"North Eastern Urology  Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2241-6635","authenticated-orcid":false,"given":"Garson","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Urology Austin Health  Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damien","family":"Bolton","sequence":"additional","affiliation":[{"name":"Department of Urology Austin Health  Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2005.11.009"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2006.09.019"},{"issue":"8","key":"e_1_2_6_4_1","first-page":"1448","article-title":"Prevalence, risk factors, and impact on health related quality of life of overactive bladder in China","volume":"30","author":"Wang Y","year":"2011","journal-title":"NeurourolUrodyn"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.11.010"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000309"},{"issue":"4","key":"e_1_2_6_7_1","first-page":"1800","article-title":"Combination of sacral neuromodulation and tolterodine for treatment of idiopathic overactive bladder in women: a clinical trial","volume":"11","author":"Tang 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