OnabotulinumtoxinA and Midurethral Sling have Comparable Outcomes for Mixed Urinary Incontinence Treatment: JAMA
USA: Researchers have found in a new study that there were no significant differences in outcomes between females treated with onabotulinumtoxinA and those who received a midurethral sling for mixed urinary incontinence. The findings, published in the Journal of the American Medical Association (JAMA), support a treatment approach that emphasizes patient preference alongside clinician guidance.
Mixed urinary incontinence, a condition marked by the simultaneous presence of stress and urgency urinary leakage, significantly impacts quality of life and poses considerable treatment challenges. Despite its prevalence, there remains a lack of comparative data on procedural interventions specifically targeting this dual-symptom profile.
In light of this gap, Heidi S. Harvie, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, and colleagues set out to evaluate whether intradetrusor onabotulinumtoxinA injections offer greater therapeutic benefit compared to midurethral sling surgery in managing mixed urinary incontinence among women.
For this purpose, the researchers conducted a randomized superiority trial across seven U.S. centers, enrolling women aged 21 and above with moderate to severe mixed urinary incontinence unresponsive to conservative or oral treatments. Participants received either a 100-unit intradetrusor injection of onabotulinumtoxinA targeting urgency or a midurethral sling surgery targeting stress incontinence. Follow-up allowed additional or crossover treatments within 6–12 months.
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