Botox for the Neurogenic Bladder

OnabotulinumtoxinA has been shown to be a safe, successful and cost effective treatment option for neurogenic detrusor overactivity improving clinical parameters and quality of life in patients with neurogenic detrusor overactivity. The most common side effects are urinary tract infections and elevated post-void residual requiring clean intermittent catheterization. The median time to retreatment is approximately 8-9 months. There appears to be little difference in efficacy or duration of treatment at 200 Units compared to 300 U and the lower dose has shown a moderately improved safety profile. Patients with multiple sclerosis and Parkinson's disease have shown benefit starting a 100 U. OnabotulinumtoxinA has also been shown to benefit patients with low detrusor compliance and those with recurrent UTIs. Treatment benefits have been shown to be durable without increased fibrosis to the detrusor. © 2013 Springer Science+Business Media New York.