Efficacy of Instillation of a Combination of Botulinum Toxin Type A and Titanium Glycerosolvate in Patients With Overactive Bladder: A Pilot Study

BACKGROUND: Overactive bladder is a common syndrome with symptoms that significantly reduce patients’ quality of life. Conventional treatment methods are not always satisfactory, prompting ongoing research into novel and effective therapeutic options. Intravesical instillations of botulinum toxin A represent one of the promising minimally invasive treatment modalities. AIM: To evaluate the efficacy of intravesical administration of a combination of titanium glycerosolvate and botulinum toxin A in patients with overactive bladder. METHODS: This clinical study included 10 patients (9 females and 1 male, mean age 63.2 ± 7.78 years) with idiopathic overactive bladder. All patients underwent a single intravesical instillation of a combination consisting of 25 mL of 40% titanium glycerosolvate solution and 500 IU of abobotulinumtoxinA diluted in 4 mL of 0.9% NaCl solution. The mean exposure time of the mixture in the bladder was 2 hours. Treatment efficacy was assessed based on voiding diaries and the Overactive Bladder Symptom Score (OABSS), completed by patients before treatment and at 1, 3, and 6 months thereafter. RESULTS: At 1 month after intravesical instillation of the experimental mixture, the mean OABSS score decreased from 10.0 ± 3.1 to 7.67 ± 3.35 (−23% compared to baseline), the frequency of urgency episodes decreased from 3.4 ± 2.78 to 1.82 ± 1.6 per day (−46.5%), the frequency of micturition decreased from 13.69 ± 3.67 to 10.4 ± 3.12 times per day (−24%), and the mean voided volume increased from 90.4 ± 74.4 to 105.6 ± 69.2 mL (+16.8%). At 3 months of follow-up, a return of overactive bladder symptom severity to baseline levels was observed in treated patients. This was evidenced by an increase in total OABSS scores, a rise in the frequency of urgency episodes and micturitions, and a decrease in mean voided volume. CONCLUSION: The results of this pilot study demonstrate the efficacy of intravesical instillation of a combination of titanium glycerosolvate and botulinum toxin A in patients with overactive bladder, with therapeutic effects persisting for up to 3 months. The observed positive clinical changes suggest that further research in this direction is warranted.