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Activity Faculty

Paul K. Tulikangas, MD, FACOG, FACS
Hartford Hospital
Hartford, Connecticut


Article Summary

Visco AG, Brubaker L, Richter HE, et al; Pelvic Floor Disorders Network. Anticholinergic therapy vs. onabotulinumtoxina for urgency urinary incontinence. N Engl J Med. 2012;367(19):1803-1813.


Introduction

Urinary urgency, frequency, and urge urinary incontinence are symptoms of overactive bladder (OAB). Almost one in five adult women in the United States is bothered by overactive bladder. Oral anticholinergic medications are a common treatment for this condition. Recently, onabotulinumtoxinA has been used to treat urinary incontinence due to detrusor overactivity associated with a neurologic condition (ex, spinal cord injury or multiple sclerosis). This is the first prospective study comparing onabotulinumtoxinA to oral anticholinergic medication in women with idiopathic OAB.


Methods

Results

Expert Opinion

This represents the first trial comparing onabotulinumtoxinA to oral anticholinergic medications for overactive bladder. The women enrolled in the trial had idiopathic overactive bladder and did not have to be anticholinergic treatment failures for enrollment. Treatment with intradetrusor onabotulinumtoxinA or an oral anticholinergic medication regimen resulted in very similar improvements in overactive bladder symptoms.

Currently, onabotulinumtoxinA is approved by the FDA for treatment of urinary incontinence due to bladder overactivity associated with neurologic conditions. Overactive bladder is a morbid condition that affects millions of women, and for most of these women, the cause of their overactive bladder is unknown. The results of this trial are exciting, and the potential for an alternative treatment for women with idiopathic OAB is encouraging for clinicians and patients alike.


Article Link

http://www.ncbi.nlm.nih.gov/pubmed