• Botulinum toxin A (BoNT-A) has been rapidly adopted as a treatment for detrusor overactivity (DO) and overactive bladder (OAB). Although it is now widely available, the evidence in support is still only moderate, comprising three small randomised trials (RCT), one dose ranging RCT numerous case series.
• A 2009 expert consensus statement advocated caution over the use of BoNT-A in idiopathic DO and recommended larger placebo controlled studies were still required. Here we report a large placebo controlled RCT commenced in 2005, before any RCT had been published.
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