Editorial
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Urol. Jul 24, 2016; 5(2): 75-79
Published online Jul 24, 2016. doi: 10.5410/wjcu.v5.i2.75
Efficacy and safety of onabotulinum toxin A for overactive bladder
Chintan K Patel, Arthur P Mourtzinos
Chintan K Patel, Arthur P Mourtzinos, Institute of Urology, Lahey Hospital and Medical Center, Burlington, MA 01805, United States
Author contributions: Patel CK played an integral role in the conception of the article, acquisition of literature and also drafted the manuscript; Mourtzinos AP is the senior author who reviewed and made critical revisions to the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chintan K Patel, MD, Resident in Urology, Institute of Urology, Lahey Hospital and Medical Center, 41 Burlington Mall Rd., Burlington, MA 01805, United States. chintan.patel@lahey.org
Telephone: +1-781-7445100
Received: March 17, 2016
Peer-review started: March 19, 2016
First decision: May 17, 2016
Revised: May 26, 2016
Accepted: July 11, 2016
Article in press: July 13, 2016
Published online: July 24, 2016
Processing time: 130 Days and 2.7 Hours
Abstract

Overactive bladder (OAB) syndrome is a condition which affects 16.9% of women and 16.2% of men with a significant negative impact on quality of life. It is a condition characterized by urgency, with or without urge incontinence, frequency and nocturia. Behavioral modifications and oral anti-muscurinic medications are first and second-line therapies for OAB but are frequently ineffective or poorly tolerated. For refractory cases of OAB, onabotulinum toxin can be offered and this therapy was approved by the Food and Drug Administration in January of 2013. In this editorial, we will review the indications, usage, efficacy and safety data for intradetrusor injection of onabotulinum toxin A.

Keywords: Onabotulinum toxin A; Botox; Overactive bladder; Overactive bladder; Neurogenic bladder; Urinary bladder; Detrusor overactivity

Core tip: Overactive bladder (OAB) remains a highly prevalent and frequently, a recalcitrant constellation of symptoms. For patients who are refractory to oral medical therapy, there is sufficient level I evidence to support the use of onabotulinum toxin A injection therapy. It is a safe and very effective 2nd line treatment for OAB, even in the elderly population. The suggested Food and Drug Administration approved dose is 100 U to maximize the benefits and minimize the adverse effects of this therapy. Risks of the intradetrusor injection of onabotulinum toxin A include urinary tract infection, increased post void residual, urinary retention which may lead to necessity of self catherization for a period of time.