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Lower-Dose Botox Effective for Detrusor Overactivity

Although 100 U injections are effective for shorter time, they cause fewer adverse events than higher doses

WEDNESDAY, Nov. 29 (HealthDay News) -- Botulinum A toxin can be used to treat patients with detrusor overactivity that is refractory to anticholinergics and 100 U injections seem to be as effective as higher doses at controlling incontinence, according to a report in the November issue of Urology.

Hann-Chorng Kuo, M.D., from the Buddhist Tzu Chi General Hospital in Hualien, Taiwan, randomly assigned 32 women and 43 men with a mean age of 63.4 years to receive either 100, 150 or 200 U of botulinum A toxin injected into the suburothelial space at 40 sites. All patients had detrusor overactivity that was refractory to anticholinergics.

After three months, the researcher found that treatment with 100, 150 and 200 U of toxin led to "excellent results" in 34.8 percent, 36 percent and 40.7 percent of patients, respectively. A smaller percentage of patients receiving 100 U of toxin had postvoid residual urine volumes of 150 mL or more compared with patients receiving higher doses. Patients receiving the higher doses had similar post-treatment urodynamic parameters but greater changes in bladder capacity and postvoid residual urine volume, the report indicates. However, a dose of 100 U was effective for a significantly shorter amount of time than higher doses.

"Suburothelial injection of 100 U of botulinum A toxin achieved a similar rate of excellent results and had significantly fewer adverse events compared with 150 or 200 U," Kuo concludes.

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