(HealthDay News) — For women with refractory urgency urinary incontinence, onabotulinumtoxinA injections may help control leakage better than the implanted nerve stimulation device InterStim, according to a study published in the Journal of the American Medical Association.

Cindy Amundsen, MD, a professor of obstetrics and gynecology at Duke University in Durham, NC, andcolleagues randomly assigned 364 women to either onabotulinumtoxinA injection or InterStim. The women had to have had at least 6 urgency incontinent episodes over 3 consecutive days. The participants were followed for 6 months.

Among women who kept track of their incontinence for at least 4 months, far more women who received onabotulinumtoxinA reported a 75 to 100% reduction in urgency incontinence symptoms compared to those using InterStim, the researchers found. Women given onabotulinumtoxinA had a greater risk of urinary tract infections, compared to women with the implant — 35 versus 11%. Also, more onabotulinumtoxinA patients needed to use a catheter to relieve urinary retention. The most common side effect for women given the implant was the need to remove or reinsert it, which occurred in just 3% of the women.

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“Among women with refractory urgency urinary incontinence, treatment with onabotulinumtoxinA compared with sacral neuromodulation resulted in a small daily improvement in episodes that although statistically significant is of uncertain clinical importance,” the authors write. “In addition, it resulted in a higher risk of urinary tract infections and need for transient self-catheterizations.”

Two authors disclosed financial ties to pharmaceutical and medical device companies, including Allergan, the manufacturer of BOTOX Cosmetic.

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1. Amundsen CL, Richter HE, Menefee SA, et al. OnabotulinumtoxinA vs Sacral Neuromodulation on Refractory Urgency Urinary Incontinence in Women. JAMA. 2016;316(13):1366-1374. doi:10.1001/jama.2016.14617.