{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:42:09Z","timestamp":1793234529414,"version":"4.5.0"},"reference-count":69,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T00:00:00Z","timestamp":1722816000000},"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>Despite the efficacy of onabotulinumtoxinA, its safety profile remains a concern. This meta-analysis reviewed the major adverse events (AEs) associated with intravesical onabotulinumtoxinA treatment in patients with neurogenic detrusor overactivity (NDO) and idiopathic overactive bladder (iOAB). Randomized controlled trials (RCTs) conducted between January 2000 and December 2022 were searched for adult patients administered different onabotulinumtoxinA dosages or onabotulinumtoxinA vs. placebo. Quality assessment was performed using the Cochrane Collaboration tool, and statistical analysis was performed using Review Manager version 5.3. A total of 26 RCTs were included in the analysis, including 8 on NDO and 18 on iOAB. OnabotulinumtoxinA vs. placebo significantly increased the urinary tract infection (UTI) incidence in patients with NDO (relative risk, or RR, 1.54) and iOAB (RR, 2.53). No difference in the RR with different onabotulinumtoxinA dosages was noted. Urinary retention was frequent with onabotulinumtoxinA use in the NDO (RR, 6.56) and iOAB (RR, 7.32) groups. Similar observations were made regarding the risks of de novo clean intermittent catheterization (CIC). The risk of voiding difficulty increased with onabotulinumtoxinA use in patients with iOAB. Systemic AEs of onabotulinumtoxinA, including muscle weakness (RR, 2.79) and nausea (RR, 3.15), were noted in patients with NDO; most systemic AEs had a low incidence and were sporadic.<\/jats:p>","DOI":"10.3390\/toxins16080343","type":"journal-article","created":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T11:28:54Z","timestamp":1722857334000},"page":"343","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Adverse Effects of Intravesical OnabotulinumtoxinA Injection in Patients with Idiopathic Overactive Bladder or Neurogenic Detrusor Overactivity: A Systematic Review and Meta-Analysis of Randomized Controlled Studies"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7228-9435","authenticated-orcid":false,"given":"Ping-Hsuan","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Urology, En Chu Kong Hospital, College of Medicine, National Taiwan University, New Taipei City 237414, Taiwan"},{"name":"Department of Urology, Taipei Veterans General Hospital, Taipei 112201, Taiwan"},{"name":"Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan"},{"name":"Shu-Tien Urological Science Research Center, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2629-4011","authenticated-orcid":false,"given":"Chung-Cheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, En Chu Kong Hospital, College of Medicine, National Taiwan University, New Taipei City 237414, Taiwan"},{"name":"Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan 320314, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0090-4295(02)02243-4","article-title":"The standardisation of terminology in lower urinary tract function: Report from the standardisation sub-committee of the International Continence Society","volume":"61","author":"Abrams","year":"2003","journal-title":"Urology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.ogc.2015.10.002","article-title":"Overactive bladder","volume":"43","author":"White","year":"2016","journal-title":"Obstet. Gynecol. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s00345-002-0301-4","article-title":"Prevalence and burden of overactive bladder in the United States","volume":"20","author":"Stewart","year":"2003","journal-title":"World J. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1097\/AOG.0b013e3181660c1b","article-title":"Prevalence and co-occurrence of pelvic floor disorders in community-dwelling women","volume":"111","author":"Lawrence","year":"2008","journal-title":"Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1002\/nau.23513","article-title":"The economic burden of overactive bladder (OAB) and its effects on the costs associated with other chronic, age-related comorbidities in the United States","volume":"37","author":"Durden","year":"2018","journal-title":"Neurourol. Urodyn."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1016\/j.eururo.2006.09.019","article-title":"Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: Results of the EPIC study","volume":"50","author":"Irwin","year":"2006","journal-title":"Eur. Urol."},{"key":"ref_7","first-page":"41","article-title":"Management of refractory overactive bladder","volume":"65","author":"Giarenis","year":"2013","journal-title":"Minerva. Ginecol."},{"key":"ref_8","first-page":"CD003193","article-title":"Anticholinergic drugs versus non-drug active therapies for non-neurogenic overactive bladder syndrome in adults","volume":"12","author":"Rai","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.curobgyn.2004.07.004","article-title":"Detrusor overactivity","volume":"14","author":"Majumdar","year":"2004","journal-title":"Curr. Obstet. Gynaecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1159\/000339600","article-title":"An overview on mixed action drugs for the treatment of overactive bladder and detrusor overactivity","volume":"89","author":"Asimakopoulos","year":"2012","journal-title":"Urol. Int."},{"key":"ref_11","first-page":"8838","article-title":"Management of refractory idiopathic overactive bladder: Intradetrusor injection of botulinum toxin type A versus posterior tibial nerve stimulation","volume":"24","author":"Sherif","year":"2017","journal-title":"Can. J. Urol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lo, C.W., Wu, M.Y., Yang, S.S., Jaw, F.S., and Chang, S.J. (2020). Comparing the efficacy of onabotulinumtoxinA, sacral neuromodulation, and peripheral tibial nerve stimulation as third line treatment for the management of overactive bladder symptoms in adults: Systematic review and network meta-analysis. Toxins, 12.","DOI":"10.3390\/toxins12020128"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Duthie, J.B., Vincent, M., Herbison, G.P., Wilson, D.I., and Wilson, D. (2011). Botulinum toxin injections for adults with overactive bladder syndrome. Cochrane Database Syst. Rev., CD005493.","DOI":"10.1002\/14651858.CD005493.pub3"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1126\/science.1123654","article-title":"SV2 is the protein receptor for botulinum neurotoxin A","volume":"312","author":"Dong","year":"2006","journal-title":"Science"},{"key":"ref_15","first-page":"16","article-title":"Kinetic studies on the interaction between botulinum toxin type A and the cholinergic neuromuscular junction","volume":"212","author":"Simpson","year":"1980","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1056\/NEJM200003023420918","article-title":"Treatment of neurogenic incontinence with botulinum toxin A","volume":"342","author":"Schurch","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.2165\/00003495-200666100-00001","article-title":"Botulinum toxin for the management of bladder dysfunction","volume":"66","author":"Schurch","year":"2006","journal-title":"Drugs"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1016\/j.juro.2015.01.087","article-title":"Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA\/SUFU guideline amendment","volume":"193","author":"Gormley","year":"2015","journal-title":"J. Urol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1016\/j.eururo.2012.08.047","article-title":"EAU guidelines on assessment and nonsurgical management of urinary incontinence","volume":"62","author":"Lucas","year":"2012","journal-title":"Eur. Urol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e32377","DOI":"10.1097\/MD.0000000000032377","article-title":"Treatment of neurogenic detrusor overactivity and overactive bladder with Botox (onabotulinumtoxinA): Development, insights, and impact","volume":"102","author":"Nitti","year":"2023","journal-title":"Medicine"},{"key":"ref_21","unstructured":"(2024, May 03). Product Information. Available online: https:\/\/www.rxabbvie.com\/pdf\/botox_pi.pdf."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1179\/2045772313Y.0000000106","article-title":"Impact of annual urodynamic evaluations on guiding bladder management in individuals with spinal cord injuries","volume":"36","author":"Linsenmeyer","year":"2013","journal-title":"J. Spinal Cord Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/j.eururo.2011.07.002","article-title":"Efficacy and safety of onabotulinumtoxinA in patients with urinary incontinence due to neurogenic detrusor overactivity: A randomised, double-blind, placebo-controlled trial","volume":"60","author":"Cruz","year":"2011","journal-title":"Eur. Urol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1016\/j.juro.2012.01.125","article-title":"Phase 3 efficacy and tolerability study of onabotulinumtoxinA for urinary incontinence from neurogenic detrusor overactivity","volume":"187","author":"Ginsberg","year":"2012","journal-title":"J. Urol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/01.ju.0000162035.73977.1c","article-title":"Botulinum toxin type a is a safe and effective treatment for neurogenic urinary incontinence: Results of a single treatment, randomized, placebo controlled 6-month study","volume":"174","author":"Schurch","year":"2005","journal-title":"J. Urol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.1016\/j.juro.2011.02.004","article-title":"Efficacy of botulinum toxin A injection for neurogenic detrusor overactivity and urinary incontinence: A randomized, double-blind trial","volume":"185","author":"Herschorn","year":"2011","journal-title":"J. Urol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1007\/s12325-013-0054-z","article-title":"OnabotulinumtoxinA is effective in patients with urinary incontinence due to neurogenic detrusor overactivity [corrected] regardless of concomitant anticholinergic use or neurologic etiology","volume":"30","author":"Ginsberg","year":"2013","journal-title":"Adv. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1002\/nau.22376","article-title":"OnabotulinumtoxinA improves urodynamic outcomes in patients with neurogenic detrusor overactivity","volume":"32","author":"Rovner","year":"2013","journal-title":"Neurourol. Urodyn."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e657","DOI":"10.1212\/WNL.0000000000005991","article-title":"Low-dose onabotulinumtoxinA improves urinary symptoms in noncatheterizing patients with MS","volume":"91","author":"Tullman","year":"2018","journal-title":"Neurology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1111\/iju.14602","article-title":"Botulinum toxin injections for Japanese patients with urinary incontinence caused by neurogenic detrusor overactivity: Clinical evaluation of onabotulinumtoxinA in a randomized, placebo-controlled, double-blind trial with an open-label extension","volume":"28","author":"Honda","year":"2021","journal-title":"Int. J. Urol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1016\/j.juro.2007.01.130","article-title":"Efficacy of botulinum toxin-A for treating idiopathic detrusor overactivity: Results from a single center, randomized, double-blind, placebo controlled trial","volume":"177","author":"Sahai","year":"2007","journal-title":"J. Urol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.juro.2008.03.028","article-title":"Refractory idiopathic urge urinary incontinence and botulinum A injection","volume":"180","author":"Brubaker","year":"2008","journal-title":"J. Urol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1002\/nau.20611","article-title":"Preliminary results of a dose-finding study for botulinum toxin-A in patients with idiopathic overactive bladder: 100 versus 150 units","volume":"28","author":"Cohen","year":"2009","journal-title":"Neurourol. Urodyn."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2608","DOI":"10.1016\/j.juro.2009.01.117","article-title":"Outcome of a randomized, double-blind, placebo controlled trial of botulinum A toxin for refractory overactive bladder","volume":"181","author":"Flynn","year":"2009","journal-title":"J. Urol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2416","DOI":"10.1016\/j.juro.2010.08.021","article-title":"Efficacy and safety of onabotulinumtoxinA for idiopathic overactive bladder: A double-blind, placebo controlled, randomized, dose ranging trial","volume":"184","author":"Dmochowski","year":"2010","journal-title":"J. Urol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"66","DOI":"10.4103\/0974-7796.82170","article-title":"Prospective randomized trial of 100u vs 200u botox in the treatment of idiopathic overactive bladder","volume":"3","author":"Altaweel","year":"2011","journal-title":"Urol. Ann."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1111\/j.1742-1241.2011.02663.x","article-title":"The safety and efficacy of botulinum toxin-A in the management of bladder oversensitivity: A randomised double-blind placebo-controlled trial","volume":"65","author":"Dowson","year":"2011","journal-title":"Int. J. Clin. Pract."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1002\/nau.21021","article-title":"Urodynamic results and clinical outcomes with intradetrusor injections of onabotulinumtoxinA in a randomized, placebo-controlled dose-finding study in idiopathic overactive bladder","volume":"30","author":"Rovner","year":"2011","journal-title":"Neurourol. Urodyn."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.eururo.2011.10.028","article-title":"Efficacy and safety of low doses of onabotulinumtoxinA for the treatment of refractory idiopathic overactive bladder: A multicentre, double-blind, randomised, placebo-controlled dose-ranging study","volume":"61","author":"Denys","year":"2012","journal-title":"Eur. Urol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.eururo.2011.12.056","article-title":"Botulinum toxin a versus placebo for refractory detrusor overactivity in women: A randomised blinded placebo-controlled trial of 240 women (the RELAX study)","volume":"62","author":"Tincello","year":"2012","journal-title":"Eur. Urol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.eururo.2013.04.001","article-title":"OnabotulinumtoxinA 100 U significantly improves all idiopathic overactive bladder symptoms and quality of life in patients with overactive bladder and urinary incontinence: A randomised, double-blind, placebo-controlled trial","volume":"64","author":"Chapple","year":"2013","journal-title":"Eur. Urol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2186","DOI":"10.1016\/j.juro.2012.12.022","article-title":"OnabotulinumtoxinA for the treatment of patients with overactive bladder and urinary incontinence: Results of a phase 3, randomized, placebo controlled trial","volume":"189","author":"Nitti","year":"2013","journal-title":"J. Urol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S1701-2163(15)31049-5","article-title":"Efficacy of botulinum toxin a intradetrusor injections for non-neurogenic urinary urge incontinence: A randomized double-blind controlled trial","volume":"35","author":"Jabs","year":"2013","journal-title":"J. Obstet. Gynaecol. Can"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1111\/ijcp.12443","article-title":"OnabotulinumtoxinA 100U provides significant improvements in overactive bladder symptoms in patients with urinary incontinence regardless of the number of anticholinergic therapies used or reason for inadequate management of overactive bladder","volume":"68","author":"Sievert","year":"2014","journal-title":"Int. J. Clin. Pract."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1590\/S1677-5538.IBJU.2014.0221","article-title":"Efficacy of botulinum toxin type A 100 Units versus 200 units for treatment of refractory idiopathic overactive bladder","volume":"41","author":"Abdelwahab","year":"2015","journal-title":"Int. Braz. J. Urol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.juro.2017.01.069","article-title":"The efficacy and safety of onabotulinumtoxinA or solifenacin compared with placebo in solifenacin na\u00efve patients with refractory overactive bladder: Results from a multicenter, randomized, double-blind phase 3b trial","volume":"198","author":"Herschorn","year":"2017","journal-title":"J. Urol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1111\/iju.14176","article-title":"OnabotulinumtoxinA (botulinum toxin type A) for the treatment of Japanese patients with overactive bladder and urinary incontinence: Results of single-dose treatment from a phase III, randomized, double-blind, placebo-controlled trial (interim analysis)","volume":"27","author":"Yokoyama","year":"2020","journal-title":"Int. J. Urol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1097\/SPV.0000000000000914","article-title":"Early and consistent improvements in urinary symptoms and quality of life with onabotulinumtoxinA in patients with overactive bladder and urinary incontinence: Results from a randomized, placebo-controlled, phase IV clinical trial","volume":"27","author":"McCammon","year":"2021","journal-title":"Female Pelvic Med. Reconstr. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Engeler, D.S., Meyer, D., Abt, D., M\u00fcller, S., and Schmid, H.P. (2015). Sacral neuromodulation for the treatment of neurogenic lower urinary tract dysfunction caused by multiple sclerosis: A single-centre prospective series. BMC Urol., 15.","DOI":"10.1186\/s12894-015-0102-x"},{"key":"ref_50","first-page":"291","article-title":"Persistence, adherence, and switch rates among extended-release and immediate-release overactive bladder medications in a regional managed care plan","volume":"14","author":"Smith","year":"2008","journal-title":"J. Manag. Care Pharm."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1111\/j.1464-410X.2009.09036.x","article-title":"Patient-reported reasons for discontinuing overactive bladder medication","volume":"105","author":"Benner","year":"2010","journal-title":"BJU Int."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"79","DOI":"10.3109\/21681805.2013.814707","article-title":"Persistence with first line anticholinergic medication in treatment-na\u00efve overactive bladder patients","volume":"48","author":"Krhut","year":"2014","journal-title":"Scand. J. Urol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.eururo.2003.12.004","article-title":"European experience of 200 cases treated with botulinum-A toxin injections into the detrusor muscle for urinary incontinence due to neurogenic detrusor overactivity","volume":"45","author":"Reitz","year":"2004","journal-title":"Eur. Urol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.eururo.2008.08.048","article-title":"Six-year follow-up of botulinum toxin A intradetrusorial injections in patients with refractory neurogenic detrusor overactivity: Clinical and urodynamic results","volume":"55","author":"Giannantoni","year":"2009","journal-title":"Eur. Urol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1016\/S0022-5347(01)66307-9","article-title":"Canine bladder blood flow and oxygenation: Changes induced by filling, contraction and outlet obstruction","volume":"155","author":"Azadzoi","year":"1996","journal-title":"J. Urol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"963","DOI":"10.4103\/0366-6999.154318","article-title":"Efficacy and safety of onabotulinumtoxinA in treating neurogenic detrusor overactivity: A systematic review and meta-analysis","volume":"128","author":"Zhou","year":"2015","journal-title":"Chin. Med. J."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Cheng, T., Shuang, W.B., Jia, D.D., Zhang, M., Tong, X.N., Yang, W.D., Jia, X.M., and Li, S. (2016). Efficacy and safety of onabotulinumtoxinA in patients with neurogenic detrusor overactivity: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0159307"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"90338","DOI":"10.18632\/oncotarget.20056","article-title":"A systematic review and meta-analysis of effectiveness and safety of therapy for overactive bladder using botulinum toxin A at different dosages","volume":"8","author":"Gu","year":"2017","journal-title":"Oncotarget"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1016\/j.urology.2014.07.046","article-title":"Incidence of adverse events after high doses of onabotulinumtoxinA for multiple indications","volume":"84","author":"Nuanthaisong","year":"2014","journal-title":"Urology"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/S0022-5347(01)66438-3","article-title":"Silent autonomic dysreflexia during voiding in men with spinal cord injuries","volume":"155","author":"Linsenmeyer","year":"1996","journal-title":"J. Urol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"(1997). Acute management of autonomic dysreflexia: Adults with spinal cord injury presenting to health-care facilities. Consortium for spinal cord. J. Spinal Cord Med., 20, 284\u2013308.","DOI":"10.1080\/10790268.1997.11719480"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/S0022-5347(05)67283-7","article-title":"Botulinum-A toxin for treating detrusor hyperreflexia in spinal cord injured patients: A new alternative to anticholinergic drugs? Preliminary results","volume":"164","author":"Schurch","year":"2000","journal-title":"J. Urol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1177\/1756287209350383","article-title":"Overactive bladder in males","volume":"1","author":"Dmochowski","year":"2009","journal-title":"Ther. Adv. Urol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/nau.22395","article-title":"The therapeutic effects of repeated detrusor injections between 200 or 300 units of onabotulinumtoxinA in chronic spinal cord injured patients","volume":"33","author":"Chen","year":"2014","journal-title":"Neurourol. Urodyn."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.urology.2012.11.010","article-title":"Long-term efficacy and safety of onabotulinumtoxinA in patients with urinary incontinence due to neurogenic detrusor overactivity: An interim analysis","volume":"81","author":"Kennelly","year":"2013","journal-title":"Urology"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med."},{"key":"ref_67","unstructured":"Higgins, J.P.T., and Green, S. (2011, March 05). Cochrane handbook for systematic reviews of interventions. Version 5.1.0. The Cochrane Collaboration. Available online: http:\/\/www.cochrane-handbook.org."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1002\/sim.1188","article-title":"Issues in the selection of a summary statistic for meta-analysis of clinical trials with binary outcomes","volume":"21","author":"Deeks","year":"2002","journal-title":"Stat. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat. Med."}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/16\/8\/343\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:30:10Z","timestamp":1760110210000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/16\/8\/343"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,5]]},"references-count":69,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["toxins16080343"],"URL":"https:\/\/doi.org\/10.3390\/toxins16080343","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,5]]}}}