Botox injections can prevent incontinence

MAYWOOD, IL – Researchers have found that Botox (onabotulinum toxin-A) injections to the bladder are as effective as medication for treating urinary urgency incontinence in women, but the injection is twice as likely to completely resolve symptoms.

The study, published in the latest issue of The New England Journal of Medicine, was conducted by a National Institutes of Health clinical trials network, including the Loyola University Chicago Stritch School of Medicine (SSOM).

Urgency incontinence is urinary incontinence with a strong or sudden need to urinate. The condition is normally treated with anticholinergics, which reduce bladder contractions by targeting the bladder muscle through the nervous system. However, these anticholinergics produce many side effects in women, such as constipation, dry mouth and dry eyes.

“Prior to this study, we reserved onabotulinum toxin-A for women who did not respond to traditional oral medication,” said Linda Brubaker, MD, MS, co-author, and dean, SSOM. “However, this research supports the use of either of these approaches as appropriate first-line treatment in women."

An estimated 15.7 percent of women in the U.S. experience urinary incontinence, with women being twice as likely to experience urinary incontinence as men.

The study evaluated 241 women with urinary urgency incontinence. One group of participants received six months of daily oral medication plus a saline injection, while another group received one injection of onabotulinum toxin-A (Botox) plus a daily oral placebo capsule.

At the beginning of the study, patients were observed to have an average of five urgency incontinence episodes a day. The average reduction in episodes over six months was 3.4 with oral medication and 3.3 with onabotulinum toxin-A. The proportion of women with complete resolution of urgency incontinence was 13 percent with anticholinergics and 27 percent with onabotulinum toxin-A.

Quality of life improved in both groups without significant differences. More participants in the anticholinergic group reported dry mouth (46 percent versus 31 percent) while the onabotulinum toxin-A group had more urinary tract infections (28 percent versus 15 percent) and more incomplete bladder emptying, requiring temporary bladder catheterization (5 percent versus 0 percent).

“These results will help doctors weigh treatment options for womenNike Series