Reports from the medical journals

Every day sees further development in the science of medicine. Dr. Evan R. Goldfischer provides an overview of some of the new medications and treatments now available to our patients.

Developments in the treatment of OAB

Pros and cons of the first OTC medication for OAB in women

The FDA has recently approved Oxytrol for Women, the first over-the-counter medication for overactive bladder (OAB). Oxybutynin, the active agent, is a wellproven drug that’s been on the market for many years, so we know its efficacy and are well-aware of its side effects.

It’s estimated that about 20 million American women have the symptoms of OAB—a strong urge and increased frequency of urination—but the majority of them don’t seek medical treatment. For these women, access to an OTC drug may be helpful in the short term. It’s certainly better than nothing.

But there are dangers to this approach. Oxytrol is delivered transdermally, via a patch, and the patch technology causes a serious skin reaction in more than ten percent of users. More significantly, the symptoms of OAB mimic those of urinary tract infection, bladder cancer, and other conditions. I am concerned that at the same time a woman prescribes a medication for herself, she may be misdiagnosing her disease.

I’m much more comfortable with a woman seeing her physician, getting a diagnosis of overactive bladder after appropriate evaluation and then, perhaps, deciding that she’d rather not take a prescription-strength drug but opt for an OTC drug. Keep in mind, however, that there’s no guarantee an OTC drug will result in savings. There are many generic agents of oxybutynin that may be covered by health plans for as little as five dollars a month, substantially less than the cost of the OTC version.

FDA expands approved uses of Botox in the treatment of OAB

In 2013, the FDA expanded the approved use of Botox to include treatment of adults with overactive bladder (OAB) who cannot use or don’t adequately respond to medications for the condition.

This is an excellent treatment and I’m pleased that we can now offer it to more patients. Botox is, however, a very powerful drug. Patients will definitely want to go to a physician who has experience with it and uses it with respect.

The Urology Division of Premier Medical Group has been using Botox for many years, in treatment and in a wide range of clinical trials. The first approved indication for botox —which we were involved in testing—was for neurogenic bladder, that is, in patients with a spinal cord injury or who had multiple sclerosis.

The new FDA approval means that this expensive drug will now be covered by insurance in additional situations, making it more affordable for the large cadre of patients now eligible for the treatment. With most of the oral agents currently used for OAB, the worst side effects experienced are dry mouth and constipation, conditions that will cease within a few days of stopping the medication. Botox, on the other hand, is an injectable drug: once it’s in your body we can’t stop it or take it away and any side effects that develop must run their course.

Premier urologists’ long experience and familiarity with the Botox procedure helps minimize such side effects and maximize the very real benefits.