Platelet-Rich Plasma Versus Botulinum Toxin for Refractory Overactive Bladder: A Randomized Trial

Exclusion Criteria

• •Pregnancy or lactation
• •Previous intravesical biological therapy (e.g., platelet-rich plasma or botulinum toxin)
• •Prior pelvic or bladder surgery that may affect bladder function
• •Active urinary tract infection or sexually transmitted infection
• •Vaginitis or chronic bacterial prostatitis
• •Bladder or lower ureteral stones confirmed by imaging
• •Bladder outlet obstruction on urodynamic study
• •Bladder malignancy (mass on imaging or malignant cells on cytology)
• •Use of indwelling urinary catheter
• •Severe uncontrolled medical conditions (e.g., uncontrolled diabetes, advanced renal or hepatic impairment)
• •Known hypersensitivity to botulinum toxin or contraindication to platelet-rich plasma preparation (e.g., coagulopathy, inability to discontinue anticoagulation safely)