Related Experiment Video
Updated: Sep 18, 2025
Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
Published on: November 9, 2016
Botulinum toxin A in idiopathic overactive bladder: a narrative review of 5410 cases
Salim Lachkar1, Ahmed Ibrahimi1, Imad Boualaoui1
1Department of Urology A, Ibn Sina University Hospital, Bettouga Avenue, Rabat, 10000, Morocco.
Introduction:
When conservative treatments fail, botulinum toxin A (BoNT-A) is an option for refractory idiopathic overactive bladder (OAB). This review evaluates the efficacy, safety, and predictive factors for BoNT-A in this situation.
Materials And Methods:
A literature search up to January 2025 was performed using PubMed, Google Scholar, and Embase to assess efficacy, safety, and predictors of adverse events (AE) related to BoNT-A. The risk of bias was assessed using the Risk of Bias 2 (RoB 2) tool for randomized studies and the Critical Appraisal Skills Programme (CASP) checklist for cohort studies. The quality of the review was evaluated based on the Oxford criteria, following the Strengthening the Assessment of Narrative Review Articles (SANRA) guidelines, and by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews.
Results:
31 studies were included, involving 5410 patients. BoNT-A improves OAB symptoms even after reinjections. Higher doses do not enhance efficacy but increase AE. AE includes high post-void residual (PVR), clean intermittent self-catheterization (CISC), and Urinary Tract Infection (UTI). Predictors of CISC include age, male gender, hysterectomy, ≥3 vaginal deliveries, mixed incontinence, prior mid-urethral sling (MUS), high PVR, low Pressure at Pdet at First Micturition (PIP1) in women, low Bladder Compliance Index (BCI) in men, and high Bladder Outlet Obstruction Index (BOOI). Diabetes and heart failure increase PVR. UTIs are more frequent in women and men with benign prostatic hyperplasia, with CISC increasing the risk fivefold. Severe complications are rare. Predictors of poor response include male gender, high BOOI, low urinary flow, and diabetes.
Discussion:
BoNT-A is effective for OAB, especially for incontinence. AE is dose-dependent and limits treatment adherence. Their link with poor response remains unclear.
Conclusion:
BoNT-A effectively treats refractory idiopathic OAB, improving symptoms and quality of life with repeated injections.
Related Concept Videos
01:17Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:23Urinary Bladder
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
01:30Urinary Tract Calculi III: Medical Management
01:26Cholinergic Antagonists: Therapeutic Uses
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
01:21Drugs for Treatment of Constipation-Predominant IBS