Botox (onabotulinum toxin-A) treatments administered to the bladder are just as likely to tackle urinary urgency incontinence problems in women as medications, and are 2 times as effective in eliminating symptoms completely, according to a recent study conducted by Loyola University Chicago Stritch School of Medicine (SSOM) and other experts from the National Institutes of Health network.
This new report coincides with a 2011 trial, which suggested that botox had been approved to help urinary incontinence in patients with neurological conditions.
Urinary incontinence occurs when urine leaks involuntarily, and is almost always due to an underlying medical condition. Urgency incontinence is the same as urinary incontinence, but accompanied by an intense, out-of-the-blue need to use the bathroom. The most common reason for urgency urinary incontinence is when detrusor muscles contract spontaneously.
This condition has traditionally been treated by prescribing medications which weaken bladder contractions (anticholinergics). Anticholinergics affect the bladder muscle via the nervous system. The problem with these medications is that women often report constipation, dry mouth, dry eyes, and other side effects.
Roughly 15.7% of women suffer from urinary incontinence, and women have a two-fold likelihood over men of developing the annoying condition. Bladder problems have been linked to diabetes and obesity; women who suffer from lack of bladder control have a higher chance of developing depression.
Linda Brubaker, MD, MS, co-author of the study and dean at SSOM commented:
“Prior to this study, we reserved onabotulinum toxin-A for women who did not respond to traditional oral medication. However, this research supports the use of either of these approaches as appropriate first-line treatment in women.”
During the trial, the researchers examined 241 women suffering from urinary urgency incontinence. Of these individuals, some were given six-months of oral drugs to be taken daily in addition to a saline shot. The others were given one shot of Botox (onabotulinum toxin-A), as well as a placebo pill to be taken every day.
When the study commenced, the participants had, on average, 5 urgency incontinence occurrences every day. Over the course of 6 months, the occurrences were reduced to 3.4 with the oral drugs and 3.3 with Botox (onabotulinum toxin-A).
Urgency incontinence completely disappeared among 13% of women who were taking anticholinergics and 27% among those taking onabotulinum toxin-A. Both groups of women showed a boost in quality of life.
In terms of side effects, 46% of patients in the anticholinergic group reported dry mouth, compared to only 31% in the onabotulinum toxin-A group. On the other hand, urinary tract infections were reported among 28% of women in the onabotulinum toxin-A group, compared with 15% in the anticholinergic group.
Incomplete emptying of the bladder was reported more among the onabotulinum group as well (5%), compared to 0% in the other group. Those who had incomplete bladder emptying problems had to be treated with catheterization.
Dr. Brubaker, continued: “These results will help doctors weigh treatment options for women and make recommendations based on individual patient needs.
According to the report, which was published in The New England Journal of Medicine, LUHS’ Division of Female Pelvic Medicine and Reconstructive Surgery is the first program of its kind in Chicago.
A study published in April of this year suggested that pelvic floor exercises may be an effective way to help women, if other treatments fail.
Written by Christine Kearney