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Posted by on Jan 7, 2016 in Urinary incontinence | 0 comments

In a nutshell

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.

Some background

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.

Methods & findings

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.

The bottom line

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

The fine print

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. 

Published By :

Neurourology and urodynamics

Date :

Nov 24, 2015

Original Title :

Efficacy and safety of onabotulinumtoxinA therapy are sustained over 4 years of treatment in patients with neurogenic detrusor overactivity: Final results of a long-term extension study.

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