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OnabotulinumtoxinA for the treatment of overactive bladder

Authors Cox L, Cameron AP

Received 6 April 2014

Accepted for publication 5 June 2014

Published 21 July 2014 Volume 2014:6 Pages 79—89

DOI https://doi.org/10.2147/RRU.S43125

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2


Supplementary video showing injection technique.

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Lindsey Cox, Anne P Cameron

Department of Urology, University of Michigan, Ann Arbor, MI, USA

Abstract: OnabotulinumtoxinA injection is a safe and effective treatment for adults with refractory overactive bladder. There is sufficient level 1 evidence to support offering onabotulinumtoxinA injections as a second-line treatment to patients who have failed behavioral therapy and oral medications such as antimuscarinics and β3 agonists. An intradetrusor injection of 100 U of onabotulinumtoxinA is likely the optimal dose to balance risks and benefits, and this is the dose approved by the US Food and Drug Administration. Improvement in urgency urinary incontinence episodes, as well as symptom scores and quality of life, were seen in around 60%–65% of patients, and were significantly improved compared with those on placebo. Most studies have reported a duration of symptom relief ranging from 6 to 12 months, with repeat injections being safe and efficacious. Overall, the risk of urinary retention was around 6% across the study populations.

Keywords: urgency urinary incontinence, urinary retention, nocturia, frequency

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