The Medical Letter on Drugs and Therapeutics
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1414
Botox for Overactive Bladder
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The FDA has recently approved intradetrusor injection of onabotulinumtoxinA (Botox – Allergan) for treatment of overactive bladder in patients who cannot tolerate or have an inadequate response to anticholinergic therapy. Botox is also approved by the FDA for use in detrusor overactivity associated with a neurologic condition such as multiple sclerosis or spinal cord injury, and for chronic migraine, upper limb spasticity, axillary hyperhidrosis, cervical dystonia, blepharospasm, strabismus, and cosmetic reduction of wrinkles.

STANDARD TREATMENT — Overactive bladder is associated with urinary urgency, frequency and nocturia, with or without incontinence. It occurs most commonly in older women. Behavioral therapy, including fluid schedules, timed voiding, Kegel exercises to strengthen pelvic muscles, weight loss, urge suppression and relaxation therapy, should be tried first.

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Title: Botox for Overactive Bladder
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