Comparing standard and reduced injections of onabotulinumtoxinA for overactive bladder treatment

Standard Injections Versus Reduced Injections for Intravesical onabotulinumtoxinA for Treatment of Idiopathic and Neurogenic Overactive Bladder: a Randomized Trial

Phase 4 Interventional Walter Reed National Military Medical Center · NCT04020510

This study is testing if fewer injections of a bladder treatment can work just as well as the usual number of injections for people with overactive bladder.

Quick facts

PhasePhase 4
Study typeInterventional
Enrollment184 (estimated)
Ages18 Years and up
SexAll
SponsorWalter Reed National Military Medical Center Federal
Locations1 site (Bethesda, Maryland)
Trial IDNCT04020510 on ClinicalTrials.gov

What this trial studies

This study aims to compare the efficacy of a reduced number of injections of onabotulinumtoxinA against the standard injection technique for treating overactive bladder. The standard method involves multiple injections with a specific dosage, while the reduced technique seeks to maintain efficacy with fewer injections. The study hypothesizes that the reduced technique will not only be equally effective but may also lead to fewer complications, such as urinary tract infections and urinary retention. Participants will be monitored for symptom improvement and any adverse events following the procedure.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older who experience urinary urgency, frequency, or urge incontinence and have not responded adequately to other treatments.

Not a fit: Patients currently using oral medications for overactive bladder or those with untreated symptomatic prolapse may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could provide a less invasive and more comfortable treatment option for patients with overactive bladder.

How similar studies have performed: Previous studies have suggested that fewer injections of onabotulinumtoxinA can still yield significant symptom improvement, indicating potential success for this approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Males or Females ≥ 18 years of age
* Predominant complaint of urinary urgency, urinary frequency or urge incontinence
* Failed at least one medication (inadequate or poorly tolerated response) or behavior modification technique (timed voiding, pelvic floor physical therapy, etc.), or decline such interventions
* Willingness to perform self-catheterization in the event of symptomatic urinary retention
* Ability to follow study instructions and likely to complete all required follow-up

Exclusion Criteria:

* Concurrent use of oral medications for treatment of OAB (anticholinergics or beta 3 agonists).
* Post void residual volume \> 200 ml
* Symptomatic prolapse \> POP-Q (Pelvic Organ Prolapse Quantification) stage 2 or greater that is untreated
* Evidence of active UTI (bladder infection)
* Any previous use of intradetrusor botulinum toxin (onabotulinumtoxinA or abobotulinumtoxinA) within the preceding 6 months
* Use of \>/= 400 units bontulinum toxin in the preceding 3months in other areas of the body
* Procedure performed in the main operating room (not outpatient setting)
* Concurrent diagnosis of interstitial cystitis/painful bladder syndrome
* Females who are pregnant or planning a pregnancy during the study or who think that they may be pregnant at the start of the study, or females of childbearing potential who are unable or unwilling to use a reliable form of contraception during the study.
* Any medical condition that may put the subject at increased risk with exposure to botulinum-A toxin, including diagnosed myasthenia gravis, Eaton-Lambert syndrome, amyotrophic lateral sclerosis/motor neuron disease, neuropathy, renal stones, or any other disorder that might interfere with neuromuscular function
* Known allergy or sensitivity to any of the components of onabotulinumtoxinA
* Concurrent participation in another investigational drug or device study that could impact the results
* Any condition or situation that, in the investigator's opinion, may put the subject at significant risk, confound the study results, or interfere significantly with the subject's participation in the study

Where this trial is running

Bethesda, Maryland

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Overactive Bladder
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.