Anticholinergic Therapy vs. OnabotulinumtoxinA for Urgency Urinary Incontinence

OnabotulinumtoxinA and anticholinergic therapy produced equivalent reductions in daily urgency urinary incontinence episodes over 6 months (3.3 vs 3.4 episodes/day reduction from a baseline of 5.0/day

Effect: null; 3.3 vs 3.4 episodes per day reduction

Women receiving onabotulinumtoxinA were significantly more likely to achieve complete resolution of urgency urinary incontinence compared to those receiving anticholinergic therapy (27% vs 13%, P=0.00

Effect: improvement; 27% vs 13%

Anticholinergic therapy caused significantly more dry mouth than onabotulinumtoxinA (46% vs 31%, P=0.02), though dry mouth was not a major cause of drug withdrawal.

Effect: adverse; 46% vs 31%

OnabotulinumtoxinA caused significantly more urinary tract infections (33% vs 13%, P<0.001) and need for catheterization at 2 months (5% vs 0%, P=0.01) compared to anticholinergic therapy, reflecting

Effect: adverse; 33% vs 13% for UTI; 5% vs 0% for catheterization at 2 months

After cessation of oral medications at 6 months, significantly fewer women in the anticholinergic group maintained adequate symptom control at month 7 compared to onabotulinumtoxinA (50% vs 62%, P=0.0

Effect: improvement; 62% vs 50% adequate control at 7 months; 38% vs 25% at 12 months