Could Botox Be the Answer for OAB?

Editor

Botox isn’t just for fuller lips and getting rid of wrinkles anymore. Two new studies suggest using botox (onabotulinumtoxinA) may help reduce or calm incontinence symptoms for those living with idiopathic OAB - or OAB of no known cause.

The first, a long-term study from NYU Langone Medical Center, suggests botox may tame symptoms for up to four years. Initially, 543 patients received either a placebo or 100U of the botoxinA treatment. Once this trial was complete, about half of the patients participated in a more long-term study. If a patient found they experienced two or more OAB episodes within three days, they were allowed to receive another botox treatment, up to six times. After receiving the botox injections, patients reported that their symptoms were reduced for an average of 7.6 months, suggesting a potential long-term effect of the treatment.

Although average time between ‘retreatment’ requests was 7.6 months, the team noted that those who received fewer treatments were able to go longer without symptoms than those who had more frequent treatments.

It is still to be determined how well the botox continues to work 10, 15 or 20 years down the road. But researchers say they have not seen any increase in negative side effects with increased treatment. And in some isolated cases, according to the study’s lead author, some patients have been treated successfully for 10 years.

In another botox trial from the Medical University of South Carolina, 227 patients who had already completed a one-year study with either 200U or 300U of the drug were put in an extension study for three years. The only restriction was that patients had to wait at least three months after one treatment to request another, if they felt they needed one. On average, patients were treated 1.5 times per year, and experienced 4.3 incontinence episodes per day.

However, by the fourth year, the average amount of incontinence episodes dropped to 3.7 events per day. Also, each yearly treatment showed consistent reduction in episodes, which again suggests the treatment can remain effective over long periods of time.

Effects of the treatment usually lasted 9.2 months. In addition, within each year of treatment, about 90 percent of the patients saw a reduction in episodes per day by 50 percent or more, with some experiencing a full 100 percent reduction.

Similarly in this study, there were no noted safety warnings or ‘signals’ associated with long term use of treatment_._

Botox has also proven to be a successful treatment for overactive bladder in women with multiple sclerosis (MS). In a series of small studies, botox - either alone or as a combination therapy - was shown to help reduce urinary dysfunction in women with MS, as well as improve sexual function both physically and emotionally. The studies suggest that by relieving physical symptoms of urinary dysfunction, other negative psychological issues can often be resolved due to improved self-image. Treatments in these studies were also shown to be effective, and well-tolerated even after long-term use.