Comparing the effectiveness and safety of 5 injections of OnabotulinumtoxinA versus the standard 20 injections for the treatment of patients with overactive bladder.

This study compared the effectiveness and safety of 5 injections of onabotulinumtoxinA (OBTA; Botox) versus the standard 20 injections for the treatment of patients with overactive bladder (OAB). The study found that a reduced technique of 5 injections of OBTA was safe and as effective as the standard technique of 20 injections for the treatment of OAB.

Overactive bladder (OAB) occurs when the bladder muscle is too active. Instead of staying at rest as urine fills the bladder, the bladder contracts. This causes a person to feel a sudden and sometimes overwhelming urge to urinate even when the bladder is not full. OAB syndrome is characterized by symptoms such as experiencing incontinence (involuntary leakage of urine), having a strong urge to urinate, and being woken up at night due to the need to urinate (nocturia). OAB symptoms can have a significant negative effect on the quality of life of patients.

The treatment options for OAB are small surgical procedures, electrical stimulation, and pharmacological drugs. When medications do not work, it can be treated with OBTA which is injected into the bladder. This treatment helps to reduce the uncontrolled contraction of the bladder muscle that causes urinary urgency. Prior studies have shown the effectiveness and safety of this therapy in the treatment of urinary symptoms.

The standard technique recommends injections of OBTA at 20 sites for the treatment of OAB. However, whether a reduced injection technique of 5 injections versus the standard 20 injections of OBTA is equally effective and safe for the treatment of OAB is still unknown.

This study involved 77 patients with OAB. Patients were randomly assigned into two groups. Group 1 included 39 patients who received 20 injections of OBTA. Group 2 included 38 patients who received 5 injections of OBTA. A questionnaire was used to assess the OAB symptoms at the start of the study and 4-12 weeks after treatment.

There was a significant improvement in both groups from the start of treatment to follow-up in terms of reducing OAB symptoms and urinary incontinence rates.

There was a greater improvement in the quality of life of patients in group 2 compared to patients in group 1. There were no significant differences between the two groups in terms of urinary incontinence rates and side effects.

Patients in group 2 were 3.8 times more likely to undergo treatment again compared to patients in group 1. There was no difference in the side effects between the two groups.

This study concluded that a reduced technique of 5 injections of OBTA was safe and as effective as the standard technique of 20 injections for the treatment of OAB.

The sample size was very small. The patients knew which treatment they were getting. This might have influenced the results. Larger studies are necessary to validate the conclusions.