These and other outcomes for effectiveness of BTX-A at different dosages in two observation periods indicate that a dose greater than 50 U is significantly more effective for certain symptoms of OAB compared with placebo .
However , there were no significant differences between some dosages .
Compared with placebo , the outcomes of total adverse events for NDO and for IDO show that doses of 300 U and 200 U for NDO are associated with more complications .
Conclusions In consideration that the treatments of BTX-A were with minimal , local , and manageable adverse effects , this meta- analysis demonstrates that BTX-A 200 U is recommended for management of NDO for short-term treatment for there was no significant difference from the larger dose of 300U .
Purpose To assess the effectiveness and safety of botulinum toxin A ( BTX-A ) at different dosages for overactive bladder ( OAB ) .
The effect of botulinum-A toxin on patients with severe urge urinary incontinence.
PURPOSE We determined the effect of 150 units of botulinum-A toxin ( Botox , Allergan , Irvine , California ) on subjects with severe urge urinary incontinence ( UUI ) . MATERIAL S AND METHODS This was an open label uncontrolled clinical trial . Subjects were recruited from the female urology and urogynecology clinics at Duke University . Inclusion criteria included evidence of UUI on 3-day bladder diary , a 24-hour pad weight of 100 gm or greater , absent or minimal stress leakage , absent detrusor dysfunction , and a history of failed anticholinergic and physical therapies . Exclusion criteria included evidence of a urinary tract infection , or other correctable or neurological etiology for UUI . The detrusor of each subject was injected with 150 units of botulinum-A toxin . Evaluations were performed at 2 weeks , 6 weeks , 3 months and 6 months after injection . Outcome measures included daily incontinence episodes , Urogenital Distress Inventory and the Incontinence Impact Question naire , 24-hour pad weights , daily pad usage and urinalysis at all visits . Urodynamic studies were performed at the 6-week and 3-month visits . RESULTS Three subjects had uncomplicated urinary tract infections during followup . No other adverse effects occurred . Statistically and clinical ly significant decreases greater than 50 % were seen in virtually all outcome measures at all visits up to 3 months . Most subjects showed signs of recurrent UUI by 6 months . All subjects reported remarkable subjective improvement in incontinence . No significant changes in maximal cystometric capacity , maximal detrusor pressure , peak flow or post-void residual volumes were seen . CONCLUSIONS Botulinum-A toxin can significantly decrease urge urinary incontinence and improve quality of life for 3 months after injection . Additional studies are needed to determine ideal doses , dosing intervals , safety and cost-effectiveness of this therapy
These and other outcomes for effectiveness of BTX-A at different dosages in two observation periods indicate that a dose greater than 50 U is significantly more effective for certain symptoms of OAB compared with placebo .
However , there were no significant differences between some dosages .
Compared with placebo , the outcomes of total adverse events for NDO and for IDO show that doses of 300 U and 200 U for NDO are associated with more complications .
Conclusions In consideration that the treatments of BTX-A were with minimal , local , and manageable adverse effects , this meta- analysis demonstrates that BTX-A 200 U is recommended for management of NDO for short-term treatment for there was no significant difference from the larger dose of 300U .
Purpose To assess the effectiveness and safety of botulinum toxin A ( BTX-A ) at different dosages for overactive bladder ( OAB ) .