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 ) .
Outcome of a randomized, double-blind, placebo controlled trial of botulinum A toxin for refractory overactive bladder.
PURPOSE We determined the effectiveness of cystoscopic administration of botulinum-A toxin compared to placebo for the treatment of urinary incontinence in subjects with idiopathic overactive bladder . MATERIAL S AND METHODS Subjects were recruited from the Division of Urogynecology at the University of Rochester . Inclusion criteria were overactive bladder refractory to anticholinergic medications , multiple daily incontinence episodes and a 24-hour pad weight of 100 gm or greater . Subjects with low leak point pressures , increased post-void residual volume or neurological etiologies were excluded from study . Subjects were r and omized to placebo or to 1 of 2 doses of botulinum-A toxin . The detrusor was injected at 8 to 10 sites above the trigone . Evaluations were performed at baseline , and at 3 and 6 weeks after injection , and included bladder diaries , pad weights , quality of life question naires and urodynamic studies . RESULTS A total of 22 subjects participated in stage 1 of this 2-stage study . We report on the outcomes of stage 1 of this study . Because stage 2 is still ongoing and investigators remain blind to the doses of botulinum-A toxin , the 2 botulinum-A toxin groups were combined for this report . There were no differences in mean baseline measurements between the 2 groups . Statistically significant improvements in daily incontinence episodes , pads changed per day and quality of life question naires were seen in the botulinum-A toxin group with no changes in the placebo group . No change in nocturia , daily voiding frequency , peak flow or detrusor pressure was seen in either group . Of 15 subjects 4 ( 26 % ) receiving botulinum-A toxin had a post-void residual volume of 200 cc or greater and 1 subject required intermittent catheterization . Four subjects experienced a urinary tract infection , 2 ( 13 % ) in the botulinum-A toxin group and 2 ( 28 % ) in the placebo group ( not significant ) . CONCLUSIONS Botulinum-A toxin can significantly reduce urge urinary incontinence due to overactive bladder at 6 weeks . However , there is a risk of urinary retention requiring self-catheterization
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 ) .