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Botulinum injections for the treatment of bladder symptoms of multiple sclerosis
Author(s) -
Kalsi Vinay,
Gonzales Gwen,
Popat Roshni,
Apostolidis Apostolos,
Elneil Sohier,
Dasgupta Prokar,
Fowler Clare J.
Publication year - 2007
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.21209
Subject(s) - medicine , nocturia , multiple sclerosis , urinary incontinence , quality of life (healthcare) , dyssynergia , urinary system , botulinum toxin , urology , surgery , nursing , psychiatry
Objective Our objective was to demonstrate the efficacy and impact on quality of life of detrusor injections of botulinum neurotoxin type A in the treatment of bladder dysfunction in patients with multiple sclerosis. Methods Forty‐three patients with multiple sclerosis suffering from severe urgency incontinence were treated with detrusor injections of botulinum neurotoxin type A. Data from cystometric assessment of the bladder, voiding diaries, quality‐of‐life questionnaires, and procontinence medication usage were collected before treatment and 4 and 16 weeks after injection. The same data were also collected after repeat treatments. Results Highly significant improvements ( p < 0.0001) in incontinence episodes and urinary urgency, daytime frequency and nocturia, were the symptomatic reflection of the significant improvements in urodynamically demonstrated bladder function. Although 98% of patients had to perform self‐catheterization after treatment, there were sustained improvements in all quality‐of‐life scores. The mean duration of effect was 9.7 months. Similar results were seen with repeat treatments. Interpretation Minimally invasive injections of botulinum neurotoxin type A have been shown to be exceptionally effective in producing a prolonged improvement in urinary continence in patients with multiple sclerosis. This treatment is likely to have a major impact on future management. Ann Neurol 2007