Botulinum Toxin for Neurogenic Bladder Due to Multiple Sclerosis

Neurogenic bladder is common in multiple sclerosis (MS) and can be refractory to pharmacologic and nonpharmacologic treatment. OnabotulinumtoxinA has been used to reduce urinary incontinence in patients with spinal cord disease, and was studied at a dose of 200 U. In the present study, researchers evaluated a lower dose — 100 U — to see if it has clinical benefit with less need for the transient complication of intermittent catheterization.

This multicenter, double-blind, placebo-controlled, manufacturer-sponsored study with 52 weeks' follow-up included 144 patients with MS, of whom 90% completed the study. Incontinence was reduced as early as week 2, from a mean 3 to 1 episodes per day. With treatment, 80% had at least 50% reduction in urin…