Botulinum toxin-A for the treatment of overactive bladder: UK contributions

J. H. Seth, C. Dowson, M. S. Khan, J. N. Panicker, C. J. Fowler, P. Dasgupta, Arun Sahai*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Background: Botulinum toxin-A (BoNT/A) is now established second-line management for refractory overactivebladder (OAB) and recognised in many incontinence guidelines and pathways. For those with neurogenic detrusoroveractivity secondary to spinal cord injury or multiple sclerosis, the toxin is currently licensed in certain parts of theworld, including the UK. It is an effective treatment in those in whom antimuscarinics and conservative measures havefailed who have symptoms of OAB and or detrusor overactivity (DO). Methods: Treatment can be given in an outpatient setting and can be administered under local anaesthesia. Its efficacylasts for between six and 12 months. Results: It has an acceptable safety profile with the biggest risk being urinary tract infection and difficulty emptying thebladder, necessitating clean intermittent self-catheterisation (CISC). Medium-term follow-up suggests repeated injectionsare also safe and efficacious. Conclusions: The mechanism of action of the toxin is more complicated than originally thought, and it seems likelythat it affects motor and sensory nerves of the bladder. In the last 10 years much of the progress of this treatment fromearly experimental trials to mainstream clinical use, and a better understanding of how it works in the bladder, are as aresult of research conducted in the UK. This review summarises the significant and substantial evidence for BoNT/A totreat refractory OAB from UK centres.

Original languageEnglish
Pages (from-to)77-83
Number of pages7
JournalJournal of Clinical Urology
Issue number2
Publication statusPublished - 1 Mar 2013


  • Botulinum toxin A
  • idiopathic detrusor overactivity
  • neurogenic detrusor overactivity
  • quality of life
  • urinary incontinence


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