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Impact of intravesical onabotulinumtoxinA (Botox) on sexual function in patients with overactive bladder syndrome: a systematic review and meta-analysis

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Abstract

Introduction and hypothesis

The association between overactive bladder (OAB) syndrome and sexual dysfunction is well documented. Intra-detrusor onabotulinumtoxinA (Botox) has proven to be effective treatment for OAB syndrome. Our aim was to examine the impact of intravesical Botox injection on sexual function in patients with OAB, by systematically reviewing the literature.

Methods

We reviewed the literature for studies that reported a change in sexual function after Botox treatment in patients suffering from OAB. This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement using pre-agreed keywords, from database inception to December 2020. Statistical analyses were performed using Review Manager (RevMan; v.5.4).

Results

Initial results yielded 455 citations. Seven articles met our inclusion criteria. One article was double-reported, leaving 6 studies in the systematic review. Three observational before-and-after studies used the Female Sexual Function Index (FSFI) with sufficient information, and therefore were included in our meta-analysis. The pooled number of participants in all studies was 119 patients. In the meta-analysis, there was significant improvement in the following domains of the FSFI after Botox injection; desire (mean difference (MD) −0.51, p = 0.02), arousal (MD −0.86, p = 0.02), lubrication (MD −0.57, p = 0.03), orgasm (MD −0.65, p = 0.0003) and satisfaction (MD −0.46, p = 0.05). Pain was the only domain that did not show improvement (MD −0.07, p = 0.79). The total FSFI score was reported in 88 patients (two studies) showing significant improvement (MD −0.77, p = 0.006).

Conclusions

We report a systematic review of the effect of Botox treatment on sexual function in patients with OAB. Although studies are small, the results indicate a positive effect in patients with OAB.

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Acknowledgements

We are grateful for the help and support provided by Heba Shawer in the editing and revision of this review and for Mrs. Carol McCormick for help with the literature search.

Funding

No external funding was used for this systematic review and meta-analysis.

Author information

Authors and Affiliations

  1. NHS Greater Glasgow and Clyde, Glasgow, UK

    Sami Shawer

  2. South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK

    Aethele Khunda & Paul Ballard

  3. Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

    Gareth J. Waring

Authors
  1. Sami Shawer
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  2. Aethele Khunda
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  4. Paul Ballard
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Contributions

Sami Shawer: project development, data collection and analysis, manuscript writing; Aethele Khunda: project development, data collection, revision of the manuscript, overall supervision, and final approval; Gareth J. Waring: project development, revision of the manuscript and supervision; Paul Ballard: supervision of the project and final approval.

Corresponding author

Correspondence to Sami Shawer.

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Conflicts of interest

Sami Shawer: no conflicts of interest; Aethele Khunda: in the last 5 years, received educational grants from Medtronic, Olympus, Axonic and speaker fees from Astellas (I also received travel and accommodation expenses from conference organisers when invited as a speaker); Gareth J. Waring: no conflicts of interest; Paul Ballard: in the last 5 years, received an educational grant from Olympus.

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Shawer, S., Khunda, A., Waring, G.J. et al. Impact of intravesical onabotulinumtoxinA (Botox) on sexual function in patients with overactive bladder syndrome: a systematic review and meta-analysis. Int Urogynecol J 33, 235–243 (2022). https://doi.org/10.1007/s00192-021-05072-7

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