Management of Overactive Bladder with Onabotulinumtoxina: Systematic Review and Meta-Analysis

To evaluate the efficacy and safety of OnabotulinumtoxinA treatment in the management of overactive bladder syndrome.

A systematic review of the literature and meta-analysis was performed including randomized controlled clinical trials that compared the use of OnabotulinumtoxinA with placebo, antimuscarinic medication, or different doses of OnabotulinumtoxinA. Eleven studies met inclusion criteria and did not have any exclusion criteria.

Improvement of urge incontinence, urinary frequency and/or urinary urgency.

adverse events (urinary tract infection, urinary retention) and quality of life. Outcomes were evaluated after a 12-week follow-up period.

independent evaluation of the study's quality using the CONSORT Tool was made. Analysis was performed in Review Manager 5.2™.

Compared with placebo, OnabotulinumtoxinA significantly decreased the number of episodes of urge incontinence. Urinary tract infection was more frequent in patients treated with OnabotulinumtoxinA compared with placebo. Frequency of urinary retention was not significantly different between patients treated with 100 IU OnabotulinumtoxinA dose versus higher doses. Quality of life was assessed with different instruments in three of the studies, this implied a limitation because it was not possible to compare these data.

Intravesical injections of OnabotulinumtoxinA showed a statistically significant improvement in the treatment of OAB compared with placebo. Adverse events were more frequent among patients treated with OnabotulinumtoxinA. This meta-analysis takes into account only randomized placebo controlled trials.

Urology. 2016 Oct 24 [Epub ahead of print]

Hugo E López Ramos, Lynda Torres Castellanos, Ingrid Ponce Esparza, Alejandro Jaramillo, Andrea Rodríguez, Camila Moreno Bencardino

Department of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana., Department of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Electronic address: ., Urologist, Department of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana., Epidemiologist, Department of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana.

Pelvic Health Weekly Newsletter