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Lee CL, Kuo HC. Long-Term Efficacy and Safety of Repeated Intravescial OnabotulinumtoxinA Injections Plus Hydrodistention in the Treatment of Interstitial Cystitis/Bladder Pain Syndrome. Toxins (Basel). 2015 Oct 22;7(10):4283-93. doi: 10.3390/toxins7104283.

OnabotulinumtoxinA, or botulinum toxin, can provide relief from symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS) when injected intravesically (i.e., directly to the bladder through a catheter). However, the effects are not sustained, so patients may undergo repeated injections. This approach of repeated injections does seem to provide a superior outcome vs. single injection, but until recently, there have been only limited data on whether the approach is truly more effective in the long term. Accordingly, investigators in this study evaluated the long-term safety and efficacy of repeated botulinum toxin injections in a group of 104 patients who had IC/BPS that didn’t respond to standard therapy. More than half of the patients received 4 doses (repeated doses every six months for up to two years) and about one-third voluntarily received a fifth injection due to worsening symptoms. The investigators noted significant improvements in symptoms and problems over the follow-up period (up to 79 months). Moreover, those patients who had repeated injections had a better success rate over the follow-up period.