Article

Botulinum toxin offers minimally invasive Tx for idiopathic OAB

Botulinum toxin A (Botox, Dysport) appears to be beneficial for the treatment of patients with idiopathic overactive bladder that is not adequately managed by anticholinergic drug therapy, according to a double-blind, placebo-controlled study presented at the European Association of Urology annual congress in Barcelona, Spain.

Botulinum toxin A (Botox, Dysport) appears to be beneficial for the treatment of patients with idiopathic overactive bladder that is not adequately managed by anticholinergic drug therapy, according to a double-blind, placebo-controlled study presented at the European Association of Urology annual congress in Barcelona, Spain.

"The benefit/risk ratio has been evaluated over a broad range of [botulinum toxin A] doses in the idiopathic OAB population, and doses of 100 U to 150 U provide the appropriate benefit/risk balance," said Chris Chapple, MD, of Royal Hallamshire Hospital, Sheffield, United Kingdom. "The clinically meaningful benefit is balanced with dose-dependant post-void residual urine volume elevation."

Patients in the study were randomized to receive either botulinum toxin A at a dose of 50 U, 100 U, 150 U, 200 U, or 300 U; or placebo. Botulinum toxin was administered as intradetrusor injections. Patients were followed for 36 weeks after treatment with assessments that included a 7-day bladder diary, post-void residual urine volume, health-related quality of life questionnaires, and urodynamics.

"We were happy to see durable and clinically meaningful efficacy for all Botox dose groups of 100 U and above with significant reductions from baseline compared to placebo in patient symptoms, including being incontinence-free," Dr. Chapple said.

Dose response was identified in efficacy parameters. However, an urge urinary incontinence analysis demonstrated minimal additional efficacy at doses above 150 U, and several health-related quality-of-life measures showed minimal incremental benefit above 100 U, Dr. Chapple said.

Look for more coverage from the EAU annual congress in the June issue of Urology Times.

Newsletter

Stay current with the latest urology news and practice-changing insights — sign up now for the essential updates every urologist needs.

© 2025 MJH Life Sciences

All rights reserved.