Komar A, Bretschneider CE, Mueller MG, et al. - Researchers examined the effectiveness of retropubic midurethral sling combined with onabotulinumtoxinA vs sling alone in improving mixed urinary incontinence symptoms. In this prospective, double-blind, randomized, controlled trial, they randomly assigned women with mixed urinary incontinence, planning to undergo midurethral sling, to receive 100 units of intradetrusor onabotulinumtoxinA or placebo during surgery. A 3-month follow-up was completed by 78 women (onabotulinumtoxinA: 41; placebo: 37). Women with mixed urinary incontinence undergoing midurethral sling placement showed no improved overall incontinence symptoms at 3 months in correlation with receiving concurrent intradetrusor onabotulinumtoxinA injection vs placebo. Significant improvement in overall incontinence symptoms occurred in women with mixed urinary incontinence undergoing sling, this was observed regardless of the addition of onabotulinumtoxinA injections. However, those provided concurrent onabotulinumtoxinA injections described less urgency severity and greater improvement in urgency symptoms at 3 months.