Amir Patel, MD, on onabotulinumtoxinA injection at the time of HoLEP

Interim data from a randomized controlled trial (NCT05878951) suggest that onabotulinumtoxinA (OTA) injection at the time of holmium laser enucleation of prostate (HoLEP) is beneficial in reducing voiding and continence symptoms in patients with overactive bladder (OAB) without increasing complications.¹

The findings were presented at the 2025 American Urological Association (AUA) Annual Meeting in Las Vegas, Nevada. In an interview with Urology Times®, lead author Amir S. Patel, MD, discussed the background and key findings from the study to date.

Overall, International Prostate Symptom Score (IPSS) and Michigan Incontinence Symptom Index (M-ISI) scores were lower in the OTA arm vs the control arm at 3 months. Specifically, the mean IPSS was 13.9 in the OTA arm vs 17.1 in the control arm. Further, the mean M-ISI score was 8.8 in the OTA arm vs 16.6 in the control arm.

Patel is an endourology fellow at Northwestern University in Chicago, Illinois.

Data also showed that IPSS and M-ISI bother scores were lower in the OTA cohort. Specifically, the mean IPSS bother score was 3.0 in the OTA arm vs 3.7 in the control arm at 3 months. Further, the mean M-ISI score was 1.8 in the OTA arm vs 3.1 in the control arm.

Based on these early findings, Patel concluded, “We think that the Botox is helping calm those symptoms down during that 3-month period, and we're seeing a significant improvement in the symptom scores in those patients and not in those patients with the control group at that 3-month period.”

REFERENCE

1. Patel AS, Xu P, Lee M, Fadl-Alla A, McDonald A, Krambeck A. Intradetrusor onabotulinum toxin A injection at time of holmium laser enucleation of prostate: an interim analysis of a randomized controlled trial. J Urol. 2025;213(5S):e203. doi:10.1097/01.JU.0001109776.58983.66.35