Comparative Efficacy and Safety if Intravesical Botulinum Toxin A Versus Platelet-Rich Plasma in the Management of Refractory Overactive Bladder : a 2 Year Study

The purpose of this prospective randomized clinical trial is to compare the efficacy andsafety of intravesical Platelet‐Rich Plasma (PRP) injection with intravesical BotulinumToxin A injection in adult patients with refractory overactive bladder (OAB) who havefailed or were intolerant to conventional medical therapy. Overactive bladder is achronic condition characterized by urinary urgency, usually accompanied by increaseddaytime frequency and nocturia, with or without urgency urinary incontinence, and has asignificant negative impact on patients' quality of life.Botulinum Toxin A is an established third‐line treatment for refractory OAB; however, itsuse may be associated with adverse events such as urinary retention, increased post‐voidresidual urine, and urinary tract infection. Platelet‐Rich Plasma has recently emerged asa regenerative therapeutic option because of its anti‐inflammatory and tissue‐repairproperties and may provide symptom improvement with fewer complications.The primary objective of this study is to compare the improvement in overactive bladdersymptoms between the two treatment groups over a 2‐year follow‐up period. Secondaryobjectives include comparing quality of life, urinary frequency, urgency episodes,urgency urinary incontinence episodes, nocturia, functional bladder capacity, post‐voidresidual urine volume, patient satisfaction, durability of treatment response, andtreatment‐related adverse events.Eligible participants will be randomly assigned to receive either intravesical BotulinumToxin A injection or intravesical Platelet‐Rich Plasma injection according to the studyprotocol. Baseline assessment will include medical history, physical examination, symptomevaluation using validated questionnaires, voiding diary, laboratory investigations, andother investigations as indicated. Participants will undergo scheduled follow‐up visitsthroughout the 2‐year study period to assess clinical response, monitor for adverseevents, and evaluate the need for additional treatment.