{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:12:17Z","timestamp":1787029937218,"version":"build-2736575974"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,4,16]],"date-time":"2022-04-16T00:00:00Z","timestamp":1650067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Registered pharmacological treatments are insufficiently effective for erectile dysfunction (ED) in around 30% of affected men. Intracavernosal injection (ICI) of ona- and abobotulinumtoxinA can reduce ED in insufficient responders. We aimed to assess the safety and effectiveness of incobotulinumtoxinA ICI as an add-on therapy to phosphodiesterase-type 5 inhibitors (PDE5-Is) or prostaglandinE1 ICIs (PGE1 ICIs) to treat ED that did not respond sufficiently to this treatment alone. We retrospectively analyzed data from 66 men with difficult to treat ED treated with single or repeated incobotulinumtoxinA 100U ICI as an add-on therapy. Response rate (increase in International Index of Erectile Function-Erectile Function domain score \u2265 the minimum clinically important difference) was 52% (median (1st\u20133rd quartile) 43.5 (34\u201371) days post-incobotulinumtoxinA ICI). ED etiology (except spinal cord injury) and severity did not influence effectiveness. Only a clinically significant response to the 1st injection predicted a request for a 2nd injection (OR = 5.6, 95%, CI 1.6\u201319.4). Three men reported mild penile pain during the injection. These results provide preliminary evidence for the effectiveness and safety of incobotulinumtoxinA ICI as an add-on therapy to treat ED that is insufficiently responsive to standard care and provides support for the multicenter randomized clinical trial NCT05196308.<\/jats:p>","DOI":"10.3390\/toxins14040286","type":"journal-article","created":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:22:43Z","timestamp":1650414163000},"page":"286","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Effectiveness and Safety of Intracavernosal IncobotulinumtoxinA (Xeomin\u00ae) 100 U as an Add-on Therapy to Standard Pharmacological Treatment for Difficult-to-Treat Erectile Dysfunction: A Case Series"],"prefix":"10.3390","volume":"14","author":[{"given":"Francois","family":"Giuliano","sequence":"first","affiliation":[{"name":"Neuro-Uro-Andrology R. Poincare University Hospital, AP-HP, 104 Bvd R. Poincare, 92380 Garches, France"},{"name":"Faculty of Medicine, Versailles Saint Quentin University, Paris Saclay, 78180 Montigny le Bretonneux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4831-6499","authenticated-orcid":false,"given":"Pierre","family":"Denys","sequence":"additional","affiliation":[{"name":"Neuro-Uro-Andrology R. Poincare University Hospital, AP-HP, 104 Bvd R. Poincare, 92380 Garches, France"},{"name":"Faculty of Medicine, Versailles Saint Quentin University, Paris Saclay, 78180 Montigny le Bretonneux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Joussain","sequence":"additional","affiliation":[{"name":"Neuro-Uro-Andrology R. Poincare University Hospital, AP-HP, 104 Bvd R. Poincare, 92380 Garches, France"},{"name":"Faculty of Medicine, Versailles Saint Quentin University, Paris Saclay, 78180 Montigny le Bretonneux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.toxicon.2020.02.006","article-title":"Neuronal Selectivity of Botulinum Neurotoxins","volume":"178","author":"Poulain","year":"2020","journal-title":"Toxicon"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/nau.22445","article-title":"Targets for Botulinum Toxin in the Lower Urinary Tract","volume":"33","author":"Cruz","year":"2014","journal-title":"Neurourol. Urodyn."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Hsieh, P.-F., Chiu, H.-C., Chen, K.-C., Chang, C.-H., and Chou, E.C.-L. (2016). Botulinum Toxin A for the Treatment of Overactive Bladder. 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