OnabotulinumtoxinA in OAB: Optimizing Persistence With Fewer Sites

OAB is a chronic, potentially debilitating condition affecting a substantial proportion of patients in urologic practice, and effective long-term management depends on systematic escalation from behavioral modification through pharmacotherapy to third-line procedural options—including onabotulinumtoxinA (Botox)—when treatment objectives are not met.

Through a methodical, patient-driven evolution from 20 injection sites to a single posterior bladder wall injection, Steven Bernstein, MD, maintained onabotulinumtoxinA (Botox) efficacy—with a greater than 93% response rate and a mean retreatment interval of 7.5 months—while substantially improving patient comfort and persistence on therapy.