Small, ongoing trial: Botox effective for motor urge incontinence in study; Described as innovative, 'exciting therapy.'.(News)

SAN DIEGO -- Injection of Botox into the detrusor muscle appears to be an effective and safe treatment option for patients with idiopathic motor or sensory urge incontinence who have failed conservative treatment, results of an open-label, ongoing trial suggested.

The study population consisted of 26 women aged 48-84 years with urodynamically proved non-neurogenic detrusor overactivity and incontinence who were resistant to conventional treatment options, Dr. Bernhard Schuessler reported at the joint annual meeting of the American Urogynecologic Society and the Society of Gynecologic Surgeons.

The women were enrolled between February 2003 and March 2004, and pretreatment evaluation consisted of history, urodynamic evaluation, voiding diary, urinalysis, and urine culture. Study participants also filled out a King's Health Questionnaire as a way to measure quality of life.

The investigators used a 23-guage needle to inject 100 U of Botox (botulinum toxin type A) into the detrusor muscle at 30 different sites, sparing the trigone. Clinical and urodynamic measurements were performed at 4, 12, and 36 weeks after the treatment, said Dr. Schuessler of the department of obstetrics and gynecology at Cantonal Hospital, Lucerne, Switzerland.

To date, 26 women have been fully evaluated at 4 weeks, 20 at 12 weeks, and 5 at 36 weeks. The subjective rate of cure, defined as being free from incontinence, was 18 of 26 patients at the 4-week visit (69%), 16 of 20 patients at 12 weeks (80%), and 1 of 5 patients at 36 weeks (20%).

The urodynamic results support the subjective cure rates. At the 4-week follow-up visit, urodynamic evaluation revealed a significant increase ...