Biomedical
Peer Reviewed
The article "Seminal papers in urology: anticholinergic therapy vs. onabotulinumtoxinA for urgency urinary incontinence" critically reviews a landmark trial comparing two primary treatments for urge urinary incontinence: anticholinergic medications and intravesical botulinum toxin A (Botox). The original study, published in 2012, was a non-inferiority, double-blinded, multi-centre randomized controlled trial that administered solifenacin (an anticholinergic) or intra-detrusor Botox to women, measuring outcomes six months post-treatment. The review highlights that while both treatments were effective, Botox had a higher rate of retention and infection, with the side effect profile being a key factor in selecting first-line therapy.
The original trial was a non-inferiority, double-blinded, multi-centre randomized controlled study. It involved administering solifenacin (5 mg daily) or a single intradetrusor injection of 100 IU of onabotulinumtoxinA to women with urgency urinary incontinence. Outcomes were measured six months post-treatment.
Both treatments were effective in reducing incontinence episodes. However, Botox had a higher rate of retention and infection. The side effect profile emerged as a key factor in selecting first-line therapy, with anticholinergic medications generally preferred due to their more favorable side effect profile.
The findings have influenced clinical guidelines by reinforcing the use of anticholinergic medications as first-line therapy for urgency urinary incontinence, with intravesical Botox considered for refractory cases. This approach balances efficacy with the side effect profiles of the treatments.
