The use of botulinum toxin for the treatment of patients with overactive bladder

Agnieszka Licow, Sylwester Ciećwież, Magdalena Ptak, Dariusz Kotlęga, Andrzej Starczewski, Agnieszka Brodowska


Overactive bladder affects 12–17% of the population, and mainly women, and its incidence increases with age. Diagnosis of this condition is based mainly on the patients’ complaints. These symptoms significantly affect the quality of life of millions of patients, involving considerable social, psychological, professional, physical and sexual problems. The wide incidence of this condition makes it necessary to find new medical substances in order to effectively eliminate the symptoms. Neurotoxins are a group of medical drugs that hold great promise for the future. Botulinum toxin is currently being used to treat  symptoms related to overactive bladder. It can constitute an appropriate therapeutic option, in  particular with regard to patients for whom the use of standard anti-cholinergic drugs is unsatisfactory or leads to severe side effects. Numerous research studies confirm that botulinum toxin can be  efficiently used in the treatment of overactive bladder. The properties of this neurotoxin allow selective  deactivation of overactive muscles. The use of botulinum toxin can be a method of treatment that significantly improves patient quality of life.
Keywords: botulinum toxin; overactive bladder; urinary incontinence; quality of life.


botulinum toxin; overactive bladder; urinary incontinence; quality of life

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Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002;21:167-78.

Verghese TS, Middleton LJ, Daniels JP, Deeks JJ, Latthe PM. The impact of urodynamics on treatment and outcomes in women with an overactive bladder: a longitudinal prospective follow-up study. Int Urogynecol J 2018;29(4);513-9. doi: 10.1007/s00192-017-3414-4.

Gulur DM, Drake MJ. Management of overactive bladder. Nat Rev Urol 2010;7(10):572-82.

Nowara A, Witek A. Naglący problem menopauzy. Prz Menopauz 2007;6:352-6.

Gormley EA, Lightner DJ, Burgio KL, Chai TC, Clemens JQ, Culkin DJ, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol 2012;188(Suppl. 6):2455-63.

Arnold J, McLeod N, Thani-Gasalam R, Rashid P. Overactive bladder syndrome – management and treatment options. Aust Fam Physician 2012;41(11):878-83.

Oskay UY, Beji NK, Yalcin O. A study on urogenital complaints of postmenopausal women aged 50 and over. Acta Obstet Gynecol Scand 2005;84(1):72-8.

Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, et al. Prevalence and burden of overactive bladder in the United States. World J Urol 2003;20(6):327-36.

Milsom I, Abrams P, Cardozo L, Roberts RG, Thüroff J, Wein AJ. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int 2001;87(9):760-6.

Sako T, Inoue M, Watanabe T, Ishii A, Yokoyama T, Kumon H. Impact of overactive bladder and lower urinary tract symptoms on sexual health in Japanese women. Int Urogynecol J 2011;22(2):165-9.

Shin JH, Kim A, Choo MS. Additional low-dose antimuscarinics can improve overactive bladder symptoms in patients with suboptimal response to beta 3 agonist monotherapy. Investig Clin Urol 2017;58(4):261-6.

Jankiewicz K, Kulik-Rechberger B, Nowakowski Ł, Rechberger T. Czynnik wzrostu nerwów (NGF) jako biomarker w diagnostyce i terapii pęcherza nadreaktywnego (OAB). Ginekol Pol 2012;83(7):532-6.

Rechberger T, Kulik-Rechberger B, Miotła P, Wróbel A. Nowa era w farmakologicznym leczeniu pęcherza nadreaktywnego (OAB): mirabegron – selektywny agonista receptora β3. Ginekol Pol 2014;85(3):214-9.

Bender S, Borowski J, Borkowski T, Torz C, Radziszewski P. Nietrzymanie moczu. Med Dypl 2011;20(6):73-80.

Jabbari B. History of botulinum toxin treatment in movement disorders. Tremor Other Hyperkinet Mov (N Y) 2016;6:394.

Drożdżyńska M, Sobieraj-Garbiak I, Chlasta A, Jastrzębska M. Toksyna botulinowa i i jej zastosowanie w medycynie. Diagn Lab 2015;51(2):139-46.

Pellett S, Bradshaw M, Tepp WH, Pier CL, Whitemarsh RCM, Chen C, et al. The light chain defines the duration of action of botulinum toxin serotype A subtypes. MBio 2018;9(2). pii: e00089-18. doi: 10.1128/mBio.00089-18.

Zeino M, Becker T, Koen M, Berger C, Riccabona M. Long-term follow-up after botulinum toxin A (BTX-A) injection into the detrusor for treatment of neurogenic detrusor hyperactivity in children. Cent European J Urol 2012;65(3):156-61.

Jasiński M, Drewa T, Tyloch J, Wolski Z. Is botulinum toxin type a intraprostatic injections really effective in patients with urinary retention? Acta Pol Pharm 2011;68(5):765-8.

Rechberger T, Wróbel A, Kokot M, Bartuzi A. Toksyna botulinowa – nowa opcja terapeutyczna w leczeniu zaburzeń czynnościowych pęcherza moczowego. Fam Med Primary Care Rev 2008;10(3):1040-4.

Gardner AP, Barbieri JT. Light Chain Diversity among Botulinum Neurotoxins. Toxins (Basel) 2018;10(7). pii: E268. doi: 10.3390/toxins10070268.

Sławek J, Rudzińska M, editor. Toksyna botulinowa w praktyce neurologicznej. Gdańsk: Via Medica; 2015.

Dykstra DD, Sidi AA, Scott AB, Pagel JM, Goldish GD. Effects of botulinum A toxin on detrusor-sphincter dyssynergia in spinal cord injury patients. J Urol 1988;139(5):919-22.

Rechberger T, Miotła P, Skorupski P, Wróbel A, Tomaszewski J. Jakość życia pacjentek z pęcherzem nadreaktywnym po zastosowaniu toksyny botulinowej – doniesienie wstępne. Ginekol Pol 2010;81:24-30.

Eldred-Evans D, Dasgupta P. Use of botulinum toxin for voiding dysfunction. Transl Androl Urol 2017;6(2):234-51.

Denys P, Dmochowski R, Aliotta P, Castro-Diaz D, Blok B, Ethans K, et al. Positive outcomes with first onabotulinumtoxinA treatment persist in the long term with repeat treatments in patients with neurogenic detrusor overactivity. BJU Int 2017;119(6):926-32.

Eldred-Evans D, Sahai A. Medium- to long-term outcomes of botulinum toxin A for idiopathic overactive bladder. Ther Adv Urol 2017;9(1):3-10.

Mohee A, Khan A, Harris N, Eardley I. Long-term outcome of the use of intravesical botulinum toxin for the treatment of overactive bladder (OAB). BJU Int 2013;111(1):106-13.

Drake MJ, Nitti VW, Ginsberg DA, Brucker BM, Hepp Z, McCool R, et al. Comparative assessment of the efficacy of onabotulinumtoxinA and oral therapies (anticholinergics and mirabegron) for overactive bladder: a systematic review and network meta-analysis. BJU Int 2017;120(5):611-22.

Sherif H, Khalil M, Omar R. Management of refractory idiopathic overactive bladder: intradetrusor injection of botulinumtoxin type A versus posterior tibial nerve stimulation. Can J Urol 2017;24(3):8838-46.

Ferreira RS, D’Ancona CAL, Oelke M, Carneiro MR. Intradetrusor onabotulinumtoxinA injections are significantly more efficacious than oral oxybutynin for treatment of neurogenic detrusor overactivity: results of a randomized, controlled, 24-week trial. Einstein (Sao Paulo) 2018;16(3):eAO4207.

Carneiro Neto JA, Santos SB, Orge GO, Tanajura D, Passos L, Oliveira CJ, et al. Onabotulinumtoxin type A improves lower urinary tract symptoms and quality of life in patients with human T cell lymphotropic virus type 1 associated overactive bladder. Braz J Infect Dis 2018;22(2):79-84.

Mühlstädt S, Mischner S, Kranz J, Anheuser P, Mohammed N, Steffens JA, et al. Quo vadis botulinum toxin: Normative constraints and quality of life for patients with idiopathic OAB?. Front Surg 2018; 5:61.


Copyright (c) 2019 Agnieszka Licow, Sylwester Ciećwież, Magdalena Ptak, Dariusz Kotlęga, Andrzej Starczewski, Agnieszka Brodowska

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