Women suffering from urinary incontinence who have not been helped by other therapies may opt for botox injections. Results of a U.S. trial suggest that botox injection, which is also commonly used to smoothen wrinkles, is slightly better than the implanted bladder control device InterStim in reducing urinary incontinence in older women.
For the study, researchers compared onabotulinumtoxinA (Botox) with InterStim when tested on patients suffering from overactive bladder who could not tolerate nor respond to other medications or treatments such as fluid restriction or pelvic floor muscle training.
The women who were involved in the study were about 63 years old, overweight or obese and had an average of six episodes of incontinence daily.
After six months, the women who received Botox injection in the bladder muscle had 3.9 fewer episodes of incontinence per day. Those in the InterStim group, on the other hand, had 3.3 fewer incidents of incontinence daily.
The difference is small but statistically meaningful. Researchers, however, said it may not be clinically important. The results are also based on twice the amount of Botox dose recommended for overactive bladder. Participants of the study received injections of 200 units of Botox, which is twice the recommended maximum dose of 100 units for overactive bladder.
Nonetheless, the Botox patients reported being more satisfied with their treatment and claimed to have experienced more reduction in symptoms.
People who have urinary incontinence experience involuntary leakage of urine, which means that they urinate when they do not want to. Also known as overactive bladder, the condition is linked to multiple pregnancies and obesity. It is also common affecting about 17 percent of women over the age of 45 and 27 percent of women over the age of 75.
"Among women with refractory urgency urinary incontinence, treatment with onabotulinumtoxinA compared with sacral neuromodulation resulted in a small daily improvement in episodes that although statistically significant is of uncertain clinical importance," study researcher Cindy Amundsen, from Duke University, and colleagues reported in their study, which was published in JAMA on Oct. 4.
Despite that Botox appeared to work better compared with implant, the women who were given Botox had increased risk of urinary tract infection. Of the participants, 35 percent of those who received Botox and 11 percent who had implant had urinary tract infection. More Botox patients also need catheter to relieve urinary retention.
The researchers, however, said that these side effects did not influence how the patients thought about the Botox treatment.