The use of Botox (onabotulinumtoxinA), no longer just limited to dermatology, has become widespread in urology in the last few years. Botox is FDA-approved to treat urge urinary incontinence as well as neurogenic detrusor overactivity. Off-label, it is used for the treatment of benign prostatic hyperplasia, interstitial cystitis, and painful bladder syndrome. For patients who fail medications for urinary symptoms, Botox injection in the bladder can be a safe and effective treatment option. Often, Botox injection into the bladder wall can be done in the outpatient setting using local anesthesia. The long-term efficacy of Botox and the number of procedures required to cure patients of incontinence remain to be seen.
A split-face, randomized, double-blind study in the journal Plastic and Reconstructive Surgery found that Botox and Xeomin, or incobotulinumtoxinA, which was recently approved by the FDA, performed similarly at identical dosages in reducing glabellar lines, crow’s feet and forehead lines. Botox, however, performed better at three days, two weeks, three months and four months when dosages were not identical and were instead determined based on studies, peer discussion and physician experience.
Cleveland, Tenn., doctor Raymond Sean Brown is facing health care fraud charges, accused of falsely billing Medicare and receiving $7.5 million in reimbursements. Brown bought 254 vials of non-FDA-approved Botox, but submitted billings to Medicare for 17,766 Botox injections, authorities claim. Brown also faces charges of money laundering, mail and wire fraud, although his lawyer maintains that Brown is not guilty.
Johnson & Johnson expects to receive FDA approval next year for a wrinkle-reducing injection similar to Allergan's Botox. Allergan already faces competition from Valeant's Dysport and Merz's Xeomin, but it has an 85% market share.
Injecting tiny amounts of Botox in points around the eyebrows yielded natural-looking results that avoided forehead paralysis or upper eyelid or eyebrow ptosis, a five-year study found. The lead investigator says he would like to license the technique.