Impact of Intravesical OnabotulinumtoxinA Therapy on Female Sexual Function in Patients with Anticholinergic-Refractory Overactive Bladder: Multicenter Retrospective Study

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Objective: To evaluate the effect of intravesical onabotulinumtoxinA therapy on female sexual function in women with anticholinergic-refractory overactive bladder (OAB) and to analyze changes in Female Sexual Function Index (FSFI) subdomains. Material and Methods: This multicenter retrospective study included sexually active women diagnosed with OAB who showed inadequate response to at least 2 anticholinergic agents or intolerance to them. All patients received 100 U onabotulinumtoxinA injected into 20 detrusor sites. Clinical assessments were performed before treatment and 12 weeks after treatment using the Overactive Bladder Questionnaire-V8 (OAB-V8), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and FSFI. Statistical analyses were conducted using IBM SPSS v26. Paired ttest or Wilcoxon signed-rank test was applied when appropriate, and p<0.05 was considered significant. Results: A total of 61 women (mean age=50.2±10.3 years) were evaluated. After treatment, OAB-V8 and ICIQ-SF scores decreased significantly (p<0.001), indicating improvement in urinary symptoms. FSFI total score increased from 18.87±1.69 to 22.77±2.01 (p<0.001). All FSFI subdomains improved significantly, with the greatest increases in orgasm and satisfaction scores (p<0.001 for both). Conclusion: Intravesical onabotulinumtoxinA improves urinary symptoms and sexual function in women with anticholinergic-refractory OAB, underscoring the importance of addressing sexual well-being in OAB management.

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