In this episode of the ICS Podcast, we explore how botulinum toxin (BoNT‑A) injection techniques for overactive bladder (OAB) are evolving—and why injection location, depth, and template may matter more than ever.

Hosted by Juan Peñafiel and Shannon Wallace, the discussion brings together two internationally recognised experts: Benoit Peyronnet (Urologist) and Michael Kennelly (Neurourologist). Together, they examine the growing evidence behind trigonal and trigone‑sparing injection strategies, challenging long‑held dogmas around reflux risk and urinary retention.

Key topics include:

• Why and when to consider trigonal or predominantly trigonal injection templates
• How injection depth, volume, and number of sites influence outcomes
• Strategies to reduce the risk of urinary retention while maintaining efficacy
• Differences in approach for idiopathic vs neurogenic OAB
• Practical tips for training, technique, and tailoring treatment to individual patients

The conversation also reflects on gaps in the current evidence base, what future trials are still needed, and how clinicians can safely adapt their practice today.

ICS Podcast

Through its annual meeting and journal, the International Continence Society (ICS) has been advancing multidisciplinary continence research and education worldwide since 1971.

Over 3,000 Urologists, Uro-gynaecologists, Physiotherapists, Nurses and Research Scientists make up ICS, a thriving society dedicated to incontinence and pelvic floor disorders. The Society is growing every day and welcomes you to join us. If you join today, you'll enjoy substantial discounts on ICS Annual Meeting registrations and free journal submissions.

Joining ICS is like being welcomed into a big family. Get to know the members and become involved in a vibrant, supportive community of healthcare professionals, dedicated to making a real difference to the lives of people with incontinence.