Botox(®) for idiopathic overactive bladder: efficacy, duration and safety. Effectiveness of subsequent injection

Abstract

Purpose: To test the efficacy, duration and safety of 100 U of botulinum toxin type A (BoNT/A) in women affected by idiopathic detrusor overactivity (IDO) and the effectiveness of subsequent injections.

Methods: In this double centre, prospective study conducted from March 2008 to March 2010, we selected women affected by IDO who failed to respond to various antimuscarinic agents, reported intolerable anticholinergic side-effects or contraindication to their use, also without any response to tibial stimulation. Medical history, physical examination, standard urodynamic examination, urinalysis, urine culture, a 4-day voiding diary and a quality of life questionnaire were requested for all patients. A total amount of 100 U of BoNT/A were injected into the detrusor muscle. A second injection of BoNT/A was suggested to patients who experienced a relapse of initially improved symptoms.

Results: We enrolled a total number of 68 women. All patients showed significant improvement in urodynamic parameters, clinical features and quality of life, after the first injection of Botox(®) until the 9 months of follow-up. Even after the second injection, with a follow-up of 3 months, we obtained results comparable with the first injection. Side-effects include an increase in post-void residual volume, dysuria and urinary infections.

Conclusions: We considered the dose of 100 U of Botox(®), for treatment of IDO, as an efficacious and safe solution compared to other therapeutic options, without serious and lasting adverse effects for women, even after a second injection.