**7. Conclusions**

The available evidence regarding BTX-A injection for refractory OAB in male patients is limited. Furthermore, most studies have combined BTX-A injection in female patients to analyze the efficacy or adverse effects of BTX-A injection. Generally, the response rate in male patients was similar to that in female patients. However, some studies have indicated that female patients exhibited better therapeutic efficacy, considering that prostate-related OAB has a different pathophysiology. However, owing to the distinct pathophysiology between men with and without BOO, patients with a small prostate and without BOO or a history of prostate surgery could have a better response and fewer adverse effects after BTX-A injection. The degree of outlet resistance may determine the efficacy of BTX-A injections in OAB symptom control. Compared with prior prostate surgeries, patients receiving RP showed better improvement in OAB symptoms and the lowest CISC rates after BTX-A injection.

Male sling and AUS were surgical choices in patients with SUI after RP. Some patients showed persistent or de novo OAB symptoms after SUI surgery. It might be feasible for patients with prior SUI surgery to receive BTX-A injections, which could improve DO and was safe. However, caution should be observed about the possible complications, despite their rarity, such as balloon perforation and urethral erosion.

**Author Contributions:** Conceptualization, writing—review and editing: H.-C.K. Methodology, writing—original draft preparation: H.-Y.L. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research was funded by the Buddhist Tzu Chi Medical Foundation grants TCMF-SP-108-01 and TCMF-MP-110-03-01.

**Institutional Review Board Statement:** Not applicable.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** Not applicable.

**Conflicts of Interest:** The authors declare no conflict of interest.
