Intradetrusor abobotulinumtoxinA (aboBoNT-A) is used off-label for refractory idiopathic overactive bladder (OAB), but real-world data on persistence are scarce. This study aimed to describe persistence and reasons for discontinuation in all treated patients and to report outcomes in those who continued treatment. We retrospectively reviewed all toxin-naïve patients who received a first injection of aboBoNT-A (500 Speywood units, 30 sites, trigone included) at a single center between 2013 and 2022; each injection was followed for at least 6 months. Of 232 patients, 97 (41.8%) received at least one repeat injection; the main reasons for stopping were loss to follow-up (17.7%), procedure cost (13.4%), adverse events (9.9%) and lack of efficacy (8.6%). Effectiveness and safety were assessed only in these 97 patients, at their last injection. The International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF) score decreased from 16.7 ± 2.8 to 12.3 ± 2.6 at 2 weeks (p < 0.001). Mean post-void residual volume rose from 16 to 79 mL (p < 0.001); 30.9% had at least 100 mL, none exceeded 200 mL and none required catheterization. The interval to re-injection was under 6 months in 24.7%, 6–12 months in 37.1% and over 12 months in 38.1%. Limitations include the retrospective design, outcome data restricted to continuers and an early outcome assessment. AboBoNT-A appears effective in patients who continue treatment, but most patients discontinue, and cost is a modifiable barrier.

Background/Objectives: Obesity and type 2 diabetes mellitus (T2DM) are associated with impaired male reproductive function. We assessed changes in semen quality and reproductive hormones during 12 months of glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy. Methods: In this prospective, single-center cohort study, 161 men with obesity and/or T2DM initiated semaglutide or liraglutide. Semen parameters, reproductive hormones, and metabolic indices were assessed at baseline and 12 months. Paired comparisons were performed in 108 completers (54 receiving each agent), with Holm adjustment for five principal semen endpoints. Total progressive motile sperm count (TPMSC) was evaluated post hoc. Baseline characteristics of completers and non-completers were compared. Results: Body mass index decreased from 37.5 to 31.3 kg/m² and HbA1c from 6.49% to 5.64%. Sperm concentration increased from 62.9 to 86.7 × 10⁶/mL, progressive motility from 22.8% to 38.4%, and normal morphology from 3.14% to 4.46% (all p < 0.001). Total sperm number increased but did not remain statistically significant after Holm correction (adjusted p = 0.062). Exploratory TPMSC increased from 42.4 to 80.9 × 10⁶/ejaculate (p < 0.001). Total testosterone increased from 5.91 to 7.74 nmol/L, whereas estradiol decreased from 36.5 to 28.4 pg/mL (both p < 0.001). Fifty-three participants (32.9%) did not complete follow-up; non-completers were older and more frequently had T2DM. Conclusions: Twelve months of GLP-1 RA therapy coincided with improved semen laboratory parameters, higher total testosterone, and improved metabolic status. The uncontrolled design and selective attrition preclude causal inference or conclusions about fertility outcomes.