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Treatment of overactive bladder with botulinum toxin type B: a pilot study

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Abstract

The purpose of this study was to determine the efficacy and safety of botulinum toxin type B (BTX-B/Myobloc) in the treatment of patients with overactive bladder. This open-label dose-escalation study enrolled 15 female patients with urinary frequency with or without incontinence. The BTX-B doses used in this study were 2500, 3750, 5000, 10 000 and 15 000 units. Response was defined as a subjective improvement in frequency, urgency and incontinence symptoms. A paired t-test of the pre/post frequency difference indicates that these 15 patients experienced an average of 5.27 fewer frequency episodes per day after treatment with BTX-B. The p value for the paired t-test was <0.001. The longest duration effect was 3 months using 10 000–15 000 units of BTX-B. The correlation between dose and duration was very significant, with a correlation coefficient = 0.96, p<0.001. Based on these findings, we feel the use of botulinum toxin to treat patients with overactive bladder warrants further study.

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Abbreviations

OAB:

Overactive bladder

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Acknowledgments

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated. The authors contributed equally to this publication.

Supported by a research grant from Elan Pharmaceuticals Inc., San Diego, CA, for the purchase of botulinum toxin type B used in this study.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, University of Minnesota, MMC 297, Minneapolis, MN 55455, USA

    Dennis Dykstra

  2. Department of Obstetrics and Gynecology, Urogynecology Division, Park Nicollet Clinic, St Louis Park, MN 55416, USA

    Al Enriquez & Michael Valley

Authors
  1. Dennis Dykstra
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  2. Al Enriquez
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  3. Michael Valley
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Corresponding author

Correspondence to Dennis Dykstra.

Additional information

Editorial Comment: The authors discuss the short-term efficacy of botulinum toxin type B in patients with overactive bladder. An attempt is made to identify the highest safe dosage, but the data presented are limited and a final recommendation regarding this requires further study. The high correlation found between dosage and duration of efficacy is very interesting and clinically relevant. Such a relationship has not been previously described for botulinum toxin type A. The duration of response is concerning and does appear to be significantly lower than that previously published and what I have personally experienced with botulinum toxin type A. Although this may be due to variations in injection technique, it may also be a result of the type of toxin used. I agree that longer-term and comparative data are warranted.

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Dykstra, D., Enriquez, A. & Valley, M. Treatment of overactive bladder with botulinum toxin type B: a pilot study. Int Urogynecol J 14, 424–426 (2003). https://doi.org/10.1007/s00192-003-1099-3

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  • DOI: https://doi.org/10.1007/s00192-003-1099-3

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