Is Botox a good long-term treatment for patients with overactive bladders?

This long-term study examined the safety and effectiveness of botulinum toxin A (onabotulinumtoxinA, OnabotA, or Botox) in the treatment of urinary incontinence in patients with overactive bladders.

Researchers concluded that OnabotA consistently improves urinary incontinence due to bladder muscle over-activity.

Bladder muscle over activity is a common cause of urinary incontinence. OnabotA is a muscle paralyzer often prescribed for the treatment of incontinence due to bladder over-activity. OnabotA is injected directly into the bladder muscle, causing it to relax and reduce episodes of urinary incontinence.

Previous studies have reported less side-effects with OnabotA injections compared to the more commonly used anticholinergic drugs. However, the long-term safety and effectiveness of OnabotA have not yet been established.

This study included 396 patients with bladder muscle over-activity, who had previously participated in a year-long OnabotA clinical trial. The purpose of this study was to examine continued treatment with OnabotA injections over the course of four years.

Before treatment, patients reported an average of 4.5 episodes of urinary incontinence per day. For six weeks following each injection, the number of incontinence episodes was consistently halved in at least 83% of patients. Over the course of the study, over 43% of patients reported a complete absence of urinary incontinence episodes.

On average, the length of time between injections was approximately 9 months. Long-term treatment with OnabotA was not associated with significant safety issues. The most common side-effects included urinary tract infections and episodes of urinary retention requiring catheter use.

Researchers concluded that OnabotA injections are a safe and effective long-term treatment for urinary incontinence in patients with increased bladder activity.

This trial only included patients with bladder muscle over-activity due to a condition of the central nervous system (such as multiple sclerosis or spinal chord injury). Result should be interpreted with care if applied to other causes of bladder muscle over-activity.