Transformative Impact of Botulinum Toxin Therapy in Overactive Bladder Management


Experts share their long-term clinical experiences with intravesical botulinum toxin type A therapy, particularly emphasizing quality of life, patient satisfaction, simplicity, safety, and the comfort patients find in its non-permanent nature.


Dr Kennelly: So let's ask a little bit about botulinum toxin. Karen, in your practice, kind of what have you seen the efficacy of it? And then-- also efficacy, tell me about any of the adverse events.

Dr Eilber: I have a little personal bias towards Botox because to me, it literally saved a patient when I first started practice. So way back 20 plus years ago, I had a patient with, I would use the term refractory OAB that we discussed before. And this patient actually had a true psychiatric, you know, depression. And she said, if you can't make me better, I really felt like I'm going to kill myself. So I started like really getting desperate looking for things. And this was way back when Botox is being studied in the pediatric population, everybody got 300 units. So of course, it worked really well. And then even after that, I continued to use it. Thankfully, you know, the studies came out. So we know what the ideal dose was. was and then eventually got FD approval. So it was covered by insurance. But I have found the Botox, you know, I don't even necessarily do your dynamics anymore. If a patient has a response to the anticholinergics, right? Those are bladder muscle relaxants. Those aren't affecting the nerves. So I know the Botox work in those patients. If it doesn't, if those medications don't work in those patients and they're really just sensor and urgent. I think those are ones again that I should really try to direct towards neuromodulation.

Dr Kennelly: Yeah, and Dr. Benson, when you're utilizing botulinum toxin therapy, kind of what has been your experience with it?

Dr Benson: Sure, I think it's been a great, great asset for so many patients, you know, it's been life -changing. And with anything, nothing's changed. and nothing's 100, nothing's perfect or terrible, it's in between. But we did a study of about 700 of our patients where we asked, would you do it again or recommend it to a friend and 85 % said yes. And I think that says a lot.

And you know, what we found is that the degree of the intervention, the simplicity, the safety, and the efficacy has been a great mix. It's just for many been a logical choice. I think I also like that it doesn't, it doesn't leave a mark, meaning that it's not permanent. So if the patient gets into botulinum toxin for some reason, it isn't their thing, it's going to wear off. It's not going to be permanent. And patients really like that. They like to know that they have a way out. Many have done some misadventures before. They may have had some misadventures. that went wrong for them and they're really hesitant. They're like, you know what? I don't want anything that's going to be permanent or in me for forever. And so when we can offer them an option that's reversible and will prove itself, they really like that.

*Video transcript is AI-generated and reviewed by Urology Times® editorial staff.

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