In a randomized study of 249 women treated for urge incontinence, Botulinum toxin A (Botox) reduced episodes from an average of 5 per day to 3.3 per day, equal to standard anticholinergic treatment, which reduced episodes to 3.4 per day.
“While anticolinergics are the first line of therapy, there are several problems with it,” said Anthony Visco, MD, representing the American Urogynecologic Societyat the late-breaking abstracts session of the American Congress of Obstetricians and Gynecologists Annual Meeting. “Long-term compliance [with anticholinergic treatment] is limited by poor efficacy and bothersome side effects.”
In the Botox group, 70% of subjects had adequate symptom control at six months; 52% had adequate control at nine months. Botox had a two-fold higher rate of complete resolution.
The drawback of using Botox, Visco said, is that it works “too well.” While it significantly reduced the number of incontinence episodes per day, it paralyzes the muscle. At two months there’s a 5% risk of a need for catheterization, and it had a higher rate of transient urinary tract infections.